
£NQRAVED£7-J.SARTAItr. — FROM A J2AGXEEJREDTZFE . 



A TREATISE 



OF 

CHILDREN, 

ACCORDING TO THE 

SIMPLE LAWS OP NATURE, WITHOUT MEDICAMENTS ; 

AND UPON THE 

BIRTH, NURSING, ATTENDANCE AND EDUCATION 
OF CHILDREN, AS WELL AS THE MOST FRE- 
QUENT DISEASES FROM THEIR VERY 
INFANCY TO THE PERIOD 
OF PUBERTY. 

Illustrated for the mass by a description of numerous cases, gathered 

DURING A PRACTICE OF 21 TEARS, 



A BOOK FOR PARENTS. 



' 



BY 



J. T. Sclionwald, I>r. M. 

from Hungary, Practical Physician and Accoucheur, Member of the Botanical Faculty 
and of the Hydro-therapeutical Institute in Vienna. 

RESIDENCE : Wilmington, N.C. 



PHILADELPHIA, 

L. A. Wollenweber, Pr., 277 North Third Street, near Noble. 

1851. 



x to* 

no 



Entered according to an Act of Congress in the year 1851. by 

J. T. SCHONWALD, Dr. M., 
in the Clerks Office for the Eastern District of Pennsylvania. 



PEEFACE. 



-00000- 



To the foundation of an edifice, if it is to endure, 
our particular attention should be directed; this foun- 
dation must be laid deeper, must be scrutinized 
more carefully, the more complicated the construc- 
tion, and the more pernicious the influences to 
which it is to be exposed. 

But where shall we find an edifice, more noble 
in its structure, but more exposed to injurious influ- 
ences than the human body. Although undoubt- 
edly created by the hand of providence for the ac- 
complishment of the highest hopes, although indis- 
putably the noblest formation of the visible world, 
there are notwithstanding thousands of obstacles to 
its development, its physical growth, from its first 
existence, from the moment of impregnation. Too 
often the child inherits from its parents, in its very 
germ, a malady, which for years they have tried in 
vain to expel from their own system, by medical 
assistance and by medicinal springs. Even from the 
grand-parents, maladies will descend upon the grand- 
children, which often produce the most disastrous 
consequences. 



IV PREFACE. 



The most numerous evils, however, which threaten 
the child, are those, which befall it at, and after its 
entrance into this world, and the very hot-bed of 
which is the nursery-room, because mothers, in their 
ignorance, are afraid to avail themselves of really 
salutary means. 

These important observations which must deeply 
affect our conscience, have induced me to commu- 
nicate from my long practice, what will be found in 
the following pages. I trust that the book will be 
useful in the nursery, and if a mother's blessing re- 
wards my labors, I shall consider myself a thousand 
fold repaid, and be induced to hasten the publica- 
tion of my large work, which has occupied me for 
the last ten years, 

THE AUTHOR. 



TO 

MRS. HENRIETTA W. REID 9 

Lady of His Excellency, the Governor of North 
Carolina. 

Madam : — 

Pure Reason and Religion teach us, that every human being, but 
particularly children, are under the care of a guardian spirit or guar- 
dian angel. 

Only when man, who, by an impenetrable decree, is allowed to act 
according to his own free will upon this earth, resists this protecting 
spirit, either through a misguided understanding, or through ill-will, 
the benevolent influence of the spirit becomes paralyzed — powerless. 
Oh ! from how many parents must not the guardian spirit have torn 
himself away, weeping for the poor children, whose fate he could no 
longer avert, and accusing the parents for having marr'd their sacred 
destiny. 

For the honor of mankind, we must suppose, that generally, it is 
the misguided understanding, which, if it does not deprive the child 
entirely of this heavenly protection upon earth, does not allow it to 
display itself in its full vigor, until prejudice, old customs and ignor- 
ance have left nothing of the poor tortured creature, but the immor- 
tal part, which is to be borne to the eternal father. We say tortured 
creature, and with right, when we consider the untold sufferings 
caused by ignorance, often by art, which attack the life of the little 
being, whose painful, plaintive sounds we do not understand. 

Particularly, when we consider, naked first infancy, exposed to 
these sufferings, does^it require, besides the guardian spirit, which 

Providence has appointed for it, a guardian angel upon this earth — 

1* 



VI DEDICATION. 

and where is there a mother more worthy of this title than you, hon- 
ored Madam, whose appearance and whose deeds upon this earth in 
general, and in the circle of your own family, resemble those of a be- 
ing from a higher sphere, watching with anxious, trembling, never- 
tiring care, and with the omnipotence of maternal affection during 
protracted sufferings, at the sick bed, over the dear life of your beloved 
off-spring 2 In the name of this trembling, loving maternal affection, 
for which there is no sacrifice too great, to seize what is right, what 
is true and what is best, and to apply it as a means to remove the evil, 
with confidence, I crave the permission to address you, and respect- 
fully to direct your attention to the absolute necessity, of having a 
single, truthful and natural system of nursing children and of treat- 
ing their diseases, the most general diffusion of which, is absolutely 
requisite, if we wish to accomplish the desirable object of diminish- 
ing the mortality, and of rearing a new, strong, and blooming race. 

Therefore, to you, most honored Madam, the guardian angel of your 
children, do I most humbly dedicate these pages for the benefit of all 
children. 

THE AUTHOR. 



©©ESrSPHEIS 1 ^. 





Page. 


Introduction, • • . • 


1 


IVIatrimony, • • . 


5 


Pregnancy, • 


11 


The Midwife, ... 


30 


Labor, • 


37 


The Child-bed, - 


45 


The Life of the new-born child from the first moment of its exit 


itence, 47 


The first care of the Infant, ... 


52 


The first Cry, 


56 


The Suckling of the Child, 


57 


The Nurse, - 


65 


The Nursery Room, - 


70 


The Bath, ... 


73 


Food, . 


79 


Clothing, • • 


87 


Exercise, . - • , 


100 


Diseases of Children in general, - 


105 


Aptha or Thrush, - 


106 


Inflammation of the eyes, • 


108 


Tongue-tie, - 


112 


The Tapeworm, • 


113 


Croup, » 


115 


Boils — Furunculus, - 


130 


Ruptures, • 


132 


Small-pox, - 


134 


Abdominal Typhus, • 


140 


Diarrhoea, • 


141 


Suffocation, . 


143 


Inflammatory Fevers, • • « 


145 


Intermittent Fevers. Fever and Ague, - 


150 


Nervous Fever, - 


153 


Hip Disease, . 


160 


Miliary Fever, . 


164 



VII 



VIII 



CONTENTS. 



Tetter, 

Enlargement of the Mesenteric Glands, 

Jaundice, 

Inflammation of the Throat, 

Hooping-cough, 

Convulsions, 

Itch, 

Scald-head, 

Colic, Pain or Spasms in the Bowels, 

Flatulency, 

Painter's Colic, 

Invagination. Intus-susception, 

Swelling of the Head of the Infant, 

Sanguineous Tumor of the Head of the Infant 

Lymphatic Swellings, 

History of a Prolapse of the Rectum, 

Crusta Lactea, 

Measles, 

Inflammation of the Ear, 

Pemphigus, 

Contusions, 

Rose rash. Roseola, 

Erysipelas, 

Tetanus and Lock-jaw, 

Scarlet Fever, 

Self-pollution, 

Tympany or Wind-dropsy, 

Over-feeding of Children, 

Water in the Head, 

Worm Disease, 

Wounds, 

The Chafing of Infants, 

The Whites, 

Dropsy, 

The Bite of a Serpent, 

Difficult Teething, 

Final Remarks, 



INTRODUCTION. 



The new-born infant is without comparison more help- 
less than the young animal, which, as soon as it escapes 
from the womb or the egg, is in most cases already provi- 
ded with a sufficient covering to protect it against many of 
the exterior impressions ; and immediately or a few days 
or weeks later, can seek its food and by means of that pow- 
erful natural desire, called instinct protect its life, and thus 
free the animal, to which it owes its existence, quickly and 
for ever from all fostering care. The child on the contrary 
must be assisted by the mother in the most trifling wants of 
life, and without her protecting care, in its helpless and dis- 
tressed condition, could not sustain life for the shortest span 
of time. 

Nature, or to speak more correctly an all-bountiful, all- 
ruling and all-wise providence has ordained that the child 
should not be helpless, has created maternal love, that 
sweet and powerful feeling which changes its own pangs, 
to joy, provided the offspring thrives ; this love we might 
compare to the all-animating sun, but that the sun sets, dis- 
appears, maternal love never. 

The actions, which are the holy and necessary result of 
this love, which are blessed by the Lord, we call a moth- 
er's duties, and in their fulfilment lies an indiscribable de- 
light for the mother, lies the life and the happiness of the 

1 



2 INTRODUCTION. 

babe. But even this maternal affection, when misguided, 
when erring in the selection of the means, can become per- 
nicious to that being, for which the mother would at all 
times be ready, to shed the last drop of her heart's blood. 
Life contains two extreme epochs, which on account of 
their helplessness, inspire us with pity : the one, the age 
of the child, the other, that of extreme old age. Both 
epochs are extremely interesting : with the age of child- 
hood we connect all the hopes of a life, full of blossoms 
and of fruit ; to old age we are attracted by veneration for 
a passed life of purity, by an unredeemable debt of grati- 
tude for favors bestowed. The child enters the world to 
unfold its blossoms, to enjoy life and to shower joy and hap- 
piness upon others ; the old man has spread happiness and 
joy, and longs for the fountain of life, for his return to God. 
Childhood is the epoch of the general development of the 
body and every particular organ, and who has to learn more 
than the child ? What a field for the practice of the eye ! 
It is well known that the child sees only plain surfaces as a 
painter produces perspective in a picture, and hence the 
child is constantly catching at objects most remote. How 
often must not the child be undeceived until it obtains an 
idea of the relations of space ! And this is only one side 
of this extremely important object. Of him, who in after 
years, could learn as much as the child learns, and must 
learn, it might in truth be said that he was a colossus in know- 
ledge, nay, that he was not far from the fountain of know- 
ledge. And are we not called upon to facilitate for the 
child its mental cultivation by proper attention to its body ! 
In the old man, whose life has been just, the body ap- 
proaches a mild dissolution, a cheerful return to its original 
state, as our forefathers were in the habit of saying; in the 
child the young life strives upwards to the light of heaven 



INTRODUCTION. 



to the splendor of the sun. But do not think that as old 
men your death will be easy unless judicious care has 
been taken of you, in your infancy ! 

It is this care, which is even much more necessary in in- 
fancy than in old age, that supports life, fortifies the con- 
stitution and promotes the development and cultivation of 
all bodily and mental capacities, it is as necessary as our food. 

The overwhelming importance of care and nursing of the 
new-born babe, as well during the first months of its entrance 
into the world, as during the whole time of its organic devel- 
opment, when the slightest impressions affect the delicate 
creature, and may deprive it of that life which has scarcely 
commenced, need not be explained to any one, who consid- 
ers that the organisation of the child has not yet obtained 
any solidity, that the development and cultivation which is 
constantly progressing, requires strength, that finally, there 
exists a constant reciprocal relation between the child and 
the world into which it has just been introduced. The num- 
ber of children, which, during the period of development, be- 
come the victims of a want of proper attention, is immense ; 
but the number of those whose life and health is sacrificed 
to false shame, fashion and vanity, to ignorance, prejudice, 
a deficient or extravagant maternal care, is unfortunately 
not less. 

There is no doubt, as the child is nursed, the man will 
grow up. The child, as can be scientifically proved, is 
more pliable than the young plant, and can be bent in any 
direction. Of a child properly organised, we may make a 
hero or a coward, a high pattern of strength or a pitiful 
specimen of weakness, a being of a higher order or an idiot, 
not far above the brute. If therefore we consider the help- 
less condition of the new offspring which fate has entirely 
entrusted to our fostering care, whose life and thriving it 



4 INTRODUCTION. 

has confided to our love, if we consider that by a rational 
care we can save our charge a host of diseases, that we can 
make his body less susceptible of them, and thus lay the 
foundation of a long, healthy and happy life, I say if we 
consider all these things, we have at once admitted the ex- 
treme importance of the care and first education of the new- 
born infant. And should not regular instruction on this sub- 
ject, be the best dower which a rational mother could be- 
stow upon her grown-up daughter ? Would not the babe 
be saved a deal of sickness and pain, and the mother a 
world of care and of trouble ? 

Dr. Stale says, " Only instruct and convince, which I 
admit is no easy matter, these thousands of mothers, who 
by over-feeding, pampering, improper clothing, or again by 
injudicious and excessive attempts at hardening, as well as 
by dietetic and pedagogic sins, cripple their children and 
make them sickly, that they are in the wrong, and the cor- 
poral defects and diseases in the rising generation will be 
diminished considerably." 

It admits of no doubt, that the care for a human being 
must begin with the dawn of its existence. Immediately 
after conception the fostering care of the embryo should 
commence, first indirectly, through the pregnant mother, 
then directly. 

This first care consists in the regular life of the mother, 
for from her the embryo, called into organic life, receives 
the juices from which it distills its own blood, from which 
again, with astonishing rapidity, develops itself its organic 
structure. The womb of the mother protects the embryo 
from inimical exterior influences, but too often it becomes 
itself the source of dangers which threaten the young life. 
And the most careful nursing will prove ineffectual when 
the child inherits already in the germ the disposition of 



MATRIMONY. 5 

disease. For whatever the eulogists of the progressive 
cultivation of the human race may say, it remains incontro- 
vertible, that with the increasing refinement of manners, 
also luxury, extravagance and debauchery have augmented, 
and that the strength of man has diminished. 

What fathers will young men make, who do not enter 
upon matrimony until they have spent their youth and 
strength in all sorts of dissipation ? What mothers will 
girls become who bestow upon their husbands nothing but 
a sickly body, a wasted soul ? 

For these reasons I consider it necessary to commence 
my treatise on the care of children from the moment of 
their conception, and to preface it by a few words on 
matrimony. 

MATRIMONY. 

Nature teaches us that matrimony is a high, a holy law, 
for the constant government of mankind, as necessary for 
the welfare of the body as of the soul ; it is the foundation 
stone of all dignified social relations, it is the keystone of 
human happiness. 

The man, who through his own fault, has not become a 
participator in this happiness, and who denies its existence, 
must not seek for an example among lovers, who are full of 
exaggerated ideas of human bliss, full of overstrained sen- 
timentality ; he should look on a well regulated household 
where man and wife are but one heart and one soul. Even 
in the lowliest hut, he will be struck by a spirit of cleanli- 
ness ; though the man be but a common laborer, a desire 
of hiding, what is offensive, will be apparent; though the 
woman be but a common drudge, he will find an attempt 
at ornament and at embellishment. 

1* 



O MATRIMONY. 

The creator, it is true, has unequally divided land and 
wealth, but upon the poorest couple, if they only strive to 
obtain it, he bestows true happiness through matrimony, 
and the same happiness he bestows on those in the higher 
walks of life. But a man may, by the accidental advan- 
tage of birth, be lord of the treasures of both the Indies, 
and yet be a bankrupt when he compares his happiness 
with the matrimonial happiness of the wood-cutter. But 
too frequently the wreath of diamonds, rubies and emeralds, 
presses with a leaden weight upon the marble brow of the 
high-born lady. But when affluence is added to matrimonial 
happiness, then, no doubt, the human existence is perfect, 
and it remains only to be wished that the never failing 
genius, with the inverted torch, may come late, but come to 
both at the same time. In short, wedlock of one man with 
only one woman, generally called monogamy, is a divine 
institution, and bestows pure and lasting happiness, as well 
upon the lowly in the poor thatched cottage, as upon the 
high in the glittering palace. To conjugal love, the fulfil- 
ment of the hardest duties becomes easy ; the truely lov- 
ing husband is strong, chaste, strives restlessly, and dares 
every thing, to make the wife happy. Conjugal love 
unites two souls into one, and matrimony may be looked 
upon as a temple, in which burns the eternal lamp of con- 
cord and contentment, which lights us over into immortality 
into the kingdom of God. 

From a pure faithful wedded life we may look for chil- 
dren, strong in body as in mind, whose entrance into the 
world is a prognostication to the parents of a happy future, 
of new bliss. 

Alas ! the East has produced polygamy, and with it the 
degradation of women to slavery, to be looked upon as 
chattels, which irrational perversion of the natural relation 



MATRIMONY. 7 

has brought in its train a number of the worst passions, and 
most unnatural crimes. And the East suffers severely for 
this, in the imbecility of the mind and the moody stupor of 
its nations, under the rule of savage tyranny ; whilst the 
western world, which honors monogamy, advances irresis- 
tibly towards a blessed state of moral liberty and mental 
culture. 

Polygamy is a purely animal condition, extinguishing the 
divine spark in man, and leading to the hellish trade of 
selling young women as chattels. No holy bond of love 
attaches there the wife to the husband, who claims only 
sensual pleasures from the slave, he despises ; who, in turn, 
hates and abhors him. 

What can be the result of such compulsory connection ? 
What else but degradation of self and of its offspring ! 

And with this foul sink of beastly lust and depravity, let 
us compare the wedded state of the christian. It is a bond 
consecrated by God, between one man and one. woman, 
which lasts through life, a union founded upon disinterested 
love, a union of souls which consecrates the flesh, a union 
which forms the foundation of all true civilization, of all the 
real success of governments. 

Matrimony, which unites the will and the deed of two 
beings into one, is the strongest barrier against idleness, in- 
dolence, effeminacy, and against all the crimes, vices and 
sufferings which they produce. 

What man, in possession of a loving wife, does not feel 
himself elevated by such bliss, does not feel his sinews grow 
stronger, his mind enlarge, his courage increase to attend 
to his calling, whatever that may be, with an ardent, un- 
paralelled zeal, to accomplish his labors with an incessant 
activity, to perform his duties with the strictest conscien- 
tiousness, that he may not only protect from want the wife 



8 MATRIMONY. 

whom God has bestowed upon him, but also prepare for her 
as much honor and temporal happiness as lies in his power ? 

And the wife, who possesses such a husband, will she not 
feel that the sphere of her action is in retirement, in her 
home ? Will not all her endeavors be directed to lighten 
the troubles of her husband, to make his home happy and 
joyous. 

Oh ! a marriage between two such beings is a temple of 
order and concord, of happiness and contentment, is, in- 
deed, a heaven upon earth. They are not only prosperous 
in their circumstances, but also the children, the offspring 
of such a marriage, sound in mind and body, grow in 
virtue and in noble activity, happy themselves, and fur- 
thering the happiness of their parents, upon whom rests 
the blessings of God, until he calls them home, to his 
eternal kingdom. That this exalted image of a happy 
state of matrimony is so seldom found in reality, must, by 
no means, be attributed to the spirit and essence of matri- 
mony, but to the perverted and cruel use which man makes 
of this divine institution. 

Where is the bliss of a harmonic, spiritual, and corporal 
union to come from, when the serious, holy bond of matri- 
mony is not formed from real heartfelt affection, but as is 
often the case, for reasons of conveniency, pride, avarice, 
or other impure motives ; how is matrimony to bestow hap- 
piness, when the husband seeks it only in sensual gratifica- 
tion and neglects his wife ? The great poet says : " For a 
whole heart a whole life must be given in return. " The 
husband must be animated with religious feelings, must ac- 
quire the strength of virtue, and act with cool intelligence, 
if he wishes to make his wife happy, establish a well regu- 
lated house, and rear an exemplary family. But how is 
he to succeed in this, when, by his conduct, he forfeits the 



MATRIMONY. 9 

esteem of his wife, or is, perhaps, thoughtless enough to 
destroy her mind by irrational tenderness. 

The female mind is susceptible of a high degree of cul- 
ture, and it behooves the husband, who has a real claim to 
this title, to exert himself, that both the heart and the un- 
derstanding of the companion, whom he has selected for 
life, may attain to a higher and higher degree of excel- 
lency. 

But when the husband is blind or mad enough to see in 
the wife, not as much a soul, which has been given into 
his keeping, as merely a body, which belongs to him, 
when he flatters her vanity, excites her love of dress, 
draws her into the vortex of company and dissipation, then 
he removes himself the first pillar of his conjugal happiness, 
and has to ascribe it to himself, when the edifice crumbles 
into ruins. Who once has entered upon this career, will 
soon seek amusements without his wife, from which every 
father of a family ought to refrain ; whilst the wife, for 
whose peace of mind he is answerable, remains at home, 
repining at his neglect, or exposed to the temptation to 
return like for like. When such a thoughtless husband 
returns home from his orgies and finds defects and faults, 
he is generally inclined to be severe, whilst the wife, not 
without reason, retorts with bitter upbraidings. 

The consequence of the repetition of such scenes is, that 
the feelings of the husband and wife become blunted; for 
convenience sake only, the appearance of affection is pre- 
served ; nay, frequently, it changes to hatred ? What is to 
become of the children in such a family. Witnessing the 
discord, the quarreling, the disputing of their parents, an 
example is before their eyes which they will not fail to 
imitate when grown up. The poor children are neglected, 
left to the care of mercenary servants, or abandoned to 



10 MATRIMONY. 

themselves, they are often ruined, both body and soul ; the 
examples of this misfortune are but too common amongst us. 

This is the sad picture of conjugal misery, whose unfor- 
tunate consequences grow like rank weeds, from whose 
seeds nothing but withered shoots sprout. These unhappy 
matrimonial relations exercise an extraordinary influence 
as well upon the physical as upon the moral development 
of the descendants. The passions of the parents, where 
real affection, true delicacy and reciprocal respects are 
strangers, degenerate into brutal lustfulness, and, perhaps, 
are gratified when the stomach is overloaded with food, or 
even in a state of intoxication ; thus they exercise, if a con- 
ception takes place under such circumstances, as pernicious 
an influence upon the bodily as upon the mental health of 
the child. Experience teaches us that such children, which 
are begotten in gluttony and inebriety, often are brutal, 
nervous, talentless, and, frequently, idiotic. 

But cohabitation, which takes place under such circum- 
stances, has also a deliterious influence upon the constitution 
of the husband and wife, and the more so, the more fre- 
quently they fail in this manner ; for the effect upon the 
digestive organs and the nervous system are very pernicious. 
Young married people, whose passions are strong towards 
each other, are apt to forget themselves so far as to weaken 
themselves by over excitement, and thus become incapable 
of procreation. The consequence of which is, that they 
accuse one another, without having an idea of the real 
cause, which is nothing else but that they indulge too fre- 
quently in that enjoyment, by which they hope to accom- 
plish their mutual most ardent wish. And because the 
prospect of this accomplishment becomes fainter and fainter, 
they have recourse to so-called "strengthening remedies," 
but never to the proper one£, namely, moderation. At 



PREGNANCY. 11 

last, the physician advises the husband to send his wife, in 
the summer, to some mineral springs, or to the sea shore, 
and himself, to go traveling for six months. The advice, 
given as the last resource, is taken, and behold the couple 
is happy ; the miraculous power of the bath is lauded to 
the skies, and yet the merit does not belong to the latter, 
but simply to the abstinence which has been practised for 
the last six months. 



PREGNANCY. 

This remarkable period of female life begins at the time 
of conception,* and its duration is generally considered forty 
weeks, two hundred and eighty days, or ten lunar months, 
which do not differ much from the calendar months. It 
must, however, be considered, that the actual monthly in- 
terval, between the menses, furnishes the real measure by 
which to determine the duration of pregnancy, as this in- 
terval must have exactly recurred ten times during preg- 
nancy. But this time is not always the same, because the 
influence of the period of menstruation, of the state of the 
mind, and of the atmosphere, can easily produce deviations, 
which may amount to a week or a fortnight. With ani- 
mals of the domestic kind, the period is sometimes still fur- 
ther prolonged. 

The influence of menstruation is such, that frequently not 
the time of conception, but the last commencement of the 
monthly courses determines the period of the birth of the 



* We shall not enter into further details respecting" conception, as 
our first object is simply to treat of the beneficial and injurious in- 
fluences upon the physical life of the foetus. For further information 
respecting " conception" the reader may refer to " the Anatomical and 
Physical Dictionary, by Piere" Vol 111. P. 802. 



12 PREGNANCY. 

child, so that, when the menses have appeared for the last 
time, a week or a fortnight before conception, the birth of 
the child occurs not two hundred and eighty days after the 
day of conception,! but a week or a fortnight earlier. In 
this calculation, we have also to attend to the time of the 
menses, as frequently, particularly during the first period of 
pregnacy the menses return, During this period an in- 
creased determination of blood to the womb and other in- 
cidental conditions exist, which, by improper conduct, such 
as reading, dancing, springing, falling and fright, particu- 
larly during the first part of pregnancy, embracing a period 
of about three months, may cause a miscarriage ; weak 
and sensitive females should therefore avoid the like causes, 
which however does not mean, that the young woman is to 
remain continually locked up in her room ; on the contrary, 
according to her constitution, she ought to take more or less 
active exercise every day, and later, namely, during the 
second period, which embraces the fourth and fifth months as 
well as in the third period, that is the sixth and seventh 
months of pregnancy, until the last month of the fourth 
period, formed by the eighth, ninth and tenth months, 
strong persons free from asthma should undertake more ac- 
tive exercise, such as climbing up mountains, driving, 
dancing, especially the last ; which is particularly advisable 
for robust individuals as contributing to the full develop- 
ment of the foetus, and to an easy and quick labor. In the 
same manner as the exercise taken by the mother effects 
the child, so, and almost still more does the diet of the 
mother influence the foetus which obtains its sustenance 
from the juices of the mother, the quality of which depends 



t See the tables in the lying-in Hospital of the Med. Surg. Academy 
of Vienna. 



PREGNANCY. 13 

upon the food she takes. The constant use of pulse and 
food prepared from flour, with a sedentary life, is apt to in- 
duce mesenteric and scrofulous diseases. 

In the first period of pregnancy, cohabitation after drink- 
ing spirituous liquors, such as, cordials, punch, wine, etc., 
often causes dropsy of the head, imbecility, and idiotism. 
Another equally injurious effect is produced upon the foetus, 
w r hen the friends of the mother, from habit, superstition, or 
ignorance, make her believe that she cannot pass the time 
of pregnancy without taking medicine, or still worse that 
at every congestion, according to the old custom, she must 
be bled . By these means she only deprives the child in her 
womb of good juices and substitutes bad ones, and the 
mother and relations ought not to be astonished if the new- 
born babe looks weak, miserable and dried-up like a 
mummy, cries day and night, and afterwards suffers from 
spasms, convulsions, mesenteric and other diseases ; the only 
cause of all this is their injudicious management. 

Pregnancy is no sickness, but a very important state of 
development of the female body, for, with it, nature com- 
mences its greatest work, the formation of a new man. 
But as this period of development increases the activity of 
the whole female nature, to a higher degree, and by dif- 
ferent influences, calls forth alterations in the female body, 
which cause frequent changes in their feelings — they are 
but too easily deceived, and together with those around 
them, take these phenomena for a disease, which, with 
proper management, suitable exercise, and fresh air, would 
mostly pass off, imperceptibly, without any further medical 
advice or drugs. But no, the physician and the mid-wife 
must be sent for, medicine must be prescribed and taken for 
the whole period of pregnancy. And is it astonishing if the 
poor woman, under all these influences, at last becomes sick 



14 PREGNANCY. 

in reality, if her labor is powerless and she cannot be de- 
livered without the assistance of other hands, or even of in- 
struments ? Need we be astonished, if such a child, in con- 
sequence of the badness or insufficiency of the food which it 
has received from the mother, and of the drugs with which 
that food has been mixed, comes into the world weak and 
sickly. But as certain as this child, under proper care and 
with wholesome milk, notwithstanding the sickly condition 
caused by the bad juices of the mother, would improve 
in a short time and recover entirely, so certain will it be- 
come more and more sickly, and at last perish entirely, not- 
withstanding all the trouble taken to save it, if its looks 
and pitiful cries induce those, who are present, through me- 
dicine, strengthening baths, and washing, to torment the 
poor creature, w T hich is not able to tell its suffering. Unfor- 
nately there is always some nurse, midw T ife, grandmother, 
or grandaunt, at hand, to administer to the poor little suf- 
ferer. For scarcely has the new-comer announced his en- 
trance into the world by some peculiar cry, when one of 
these persons appears with some decoction, mostly of tea, 
in order to free the child of its supposed pains, nay, we see 
but too frequently, that in nursery rooms such a decoction 
is given as a common beverage to a child, which in the 
womb of the mother has received nothing but bad food, and 
was ushered into this world having the appearance of a 
mummy. These persons think that this beverage cannot 
be very injurious to the child, they are not aware that it is 
a poison for the tender plant, that through the exciting 
power which it exercises upon the nervous and vascular 
system, it acts perniciously, and in a new-born babe may 
produce griping, spasms, and other diseases. 

As we have already mentioned, pregnancy is no sick- 
ness, for the accompanying symptoms, such as lassitude, a 



PREGNANCY. 15 

hitherto unknown degree of weakness, inclination to sleep, 
increased circulation, palpitation of the heart, shuddering 
followed by sudden heat, increased appetite and thirst, in- 
clination to vomit, real vomiting, headache and toothache, 
a particular sensitiveness and excitability, afterwards con- 
stipation of the bowels, inclination to pass urine, pains in 
the small of the back, swelled feet, etc., are the natural 
consequences of pregnancy, depending upon the period of 
conception and development, (a process going on in the 
body of the mother) and upon the constitution, which, per- 
iodically, come and disappear, without any further inter- 
ference, and which are generally considered as so many 
symptoms of an existing pregnancy. 

But even when all these symptoms concur, we cannot 
always calculate with certainty, that a female is pregnant, 
because the same symptoms occur, more or less, in females 
under other circumstances. With more certainty, however, 
we may infer a real pregnancy, when the menses do not 
appear for a month or more, or when they appear at an un- 
usual time, when the abdomen about the hips begins to ex- 
pand gradually and to become rounder, when the breasts 
enlarge, and single darting pains penetrate to the nipples, 
and in the morning drops of a clear fluid exude from them ; 
but all this is only probability, not certainty, the only sure 
sign of an existing pregnancy for the young mother is, when 
she feels the child move. 

There are, no doubt, many symptoms of an existing 
pregnancy by which the physician in particular may be 
guided ; but the most infallible, no doubt, is the quickening 
or moving of the child, which, generally, is observed be- 
tween the seventeenth and twentieth week, which first ap- 
pears like sharp, pricking blows in the abdomen, and which 
later, particularly towards the end of pregnancy, becomes 



16 PREGNANCY. 

stronger and more frequent, and too often troublesome. As 
it cannot be my object to follow the pregnancy through its 
different periods : the act of conception, the change in the 
womb, the formation of the embryo and its developments 
until it is a perfect child, which is the business of " Gy- 
cology," I shall leave the subject and proceed at once to 
my task, namely, to define what is beneficial and what is in- 
jurious to the health of the foetus, which includes also the 
dietetic treatment during pregnancy. 

This treatment may be divided into two parts, in that of 
the mind, and that of the body. Nothing is more de- 
sirable for a pregnant woman, than that she should pos- 
sess ease of mind and cheerfulness, and that supported by 
joyous hopes for a fair future, with affections towards her 
husband, without any fear, she might expect the moment 
when she presents to the world her offspring, a new man. 
For when the mind is quiet and cheerful, not subject to 
irritations, free of humors, enjoying every hour of life, then 
the fruit which she bears in her bosom will thrive, and come 
into the world blooming and hopeful. When, on the con- 
trary, the young woman, formed too sanguine expectations 
of the marriage state, dreamed of an ideal pastoral life, 
which is not to be found upon earth, and in a few weeks 
or months was undeceived ; when convenience has conclud- 
ed the marriage, and no heartfelt, rational affection exists 
on either side, then, the otherwise gentle creature gener- 
ally changes her behavior. Then the young wife, thinking 
herself justified by her maternal feelings, gives way to her 
passions, which will increase, if the husband does not know 
by reason, love and friendship, to restrain them within 
bounds. All the equanimity of her sex forsakes her, and 
the otherwise gentle soul can bear nothing now, is impatient 
at the most trifling inconveniences, weary of her burden, is 



PREGNANCY. 17 

unreliable, inconstant in her wishes, hopes, words, praise 
and blame. Then love too often changes to hatred ; she 
adopts an artificial conduct which deceives those who ought 
to be dear to her, and thus deprives them of all the joy which 
they had a right to expect from the connubial connection. 

These uncertain feelings, this humorsome conduct is 
followed by anger, jealousy, inclination to discord and 
quarreling, a never gratified longing after some unknown 
something, which again is succeeded by sadness, fear and 
terror, with which the mother torments both herself and 
the child which she bears. 

If under these injurious influences the child lives, there 
is no doubt that such passions must hurt both the mother 
and the child, and increase the difficulties at the time of de- 
livery, because passions of any kind not only disturb the 
mind, but also undermine the health of the young woman, 
giving rise to very grave disturbances of the nervous system, 
such as congestion, fever, excess of bile, loss of appetite, 
and a whole host of diseases. 

A similar injury, as that, produced by the influences just 
now enumerated, is caused to the health of the mother and 
of the child, by that sentimentality which in our times is 
increasing so much, by a disposition to melancholy, pondering 
at misfortunes which may come to pass, by terror, fear of fu- 
ture events, invention of causes, which in their effects, may 
produce vexation, grief, sadness, sorrow, etc. But as it is 
written in the book of fate, that no human being runs 
through his worldly career without being, at least, some- 
times, visited by vexation, grief and sadness, and although 
this is particularly true of the mothers of families, with 
whom it happens that, just during the time of pregnancy, 
there are many causes which might affect their disposition 
unavoidably, still they have it in their power to control 



18 



PREGNANCY. 



them by reason, that is to say, if their education has been 
of the right kind, and they consider that all the fretting 
does not change the past, and what is most important, that 
the child which they bear, will suffer from it as much as 
their own constitution, whilst a firm determination can 
counteract these injurious influences. 

This victory over themselves, pregnant women will not 
obtain however, if they give way to their imagination, 
which points out to them a sad future, when every day, they 
become more terrified as to the result of their preg- 
nancy, allow no remonstrance, no reasoning to alter their 
once formed opinions, adhering to them obstinately to the 
last moment, namely, that they will have difficult labor, 
that their own life or that of their child will be sacrificed, 
that on account of a sudden fright or the unexpected sight 
of a deformed or crippled being, they may bring into the 
world a crippled child, or may have a miscarriage, which 
fear is particularly strong with those who have already 
been unfortunate in this respect. With such despondency 
and continuing fear, it is easy, when these emotions have 
weakened the pregnant woman to a great degree, that at 
the most trivial fright or mechanical concussion, her fears 
become realized, that her child is brought into the world, 
unable to live, that she thus destroys the hope which she 
and her friends have fostered so long, in short that she kills 
her child. Here, strength of mind is wanted to root up ima- 
ges which rest upon unfounded suppositions, here, there is a 
want of that information which every mother should im- 
part to her daughter as a dowery w T hen she gets married. 

Where superstition prevails, and a woman in our times 
believes in evil wishes, an evil eye, overlooking, etc., there 
the fault lies in the education, and we have many instances 
where the ever increasing activity of the nervous system 



PREGNANCY. 19 

becomes destructive of the health of the mother and of the 
child. May this therefore induce every mother to give to 
her marriageable daughter correct ideas of the natural 
course of a pregnancy. 

Every woman who thus frets and worries herself, we 
should advise to go to one of the Lying-in Hospitals in 
Vienna, Berlin, Naples, Paris, etc., and convince herself 
that of the pregnant women, who before their entrance into 
these institutions, have lived under various circumstances 
and under very different influences, of the immense number 
of the births which take place every year, scarcely one in 
sixty requires any artificial assistance ; that scarcely one 
child in a thousand is born with a defect, and that years 
will pass before a single monster is born, and that the latter 
is neither in consequence of fright or disagreeable sights 
during pregnancy, but that it had its cause in the defective 
original formation or development of the child. 

By this means the woman will have an opportunity of 
convincing herself that without a particular mechanical in- 
fluence, without malformation in the mother, and without 
her own fault, no accidents occur. These women, who 
have not strength of mind enough, who find neither plea- 
sure nor amusement in their household occupations, who 
have not sufficient confidence in the all-wise providence and 
goodness of God, should, at least, look for entertainment 
and amusement in the circle of their friends, in the fair 
scenes of nature, in useful and cheerful reading, in order to 
guard against despondency and fear, and to protect their 
health and that of the child. 

As to the dietetic rules of pregnant women, they may be 
considered under the heads of air, cleanliness, food, clothing, 
rest and exercise. 

Let the air be pure. The dwelling therefore ought to be 



20 PREGNANCY. 

spacious, sunny, free of all vapors, particularly of those of 
coal; it should at all seasons, be aired once a day. 
Staying several hours in the open air daily, is also very 
advisable. The constant companion and just pride of 
woman is cleanliness, wherefore I shall only mention here 
how it is to be applied to the body during pregnancy. 

It is generally known that the cleanliness of the skin is 
an important object of health, it being the organ which 
forms the connection with the outer world ; that the pores, 
when not obstructed, do not only facilitate the exudation of 
what is superfluous, but also absorb the air or its animating 
spirit, conduct it through the mass of the juices to the 
blood, thereby increasing its circulation, or in a manner re- 
gulating it. For this reason we find the healthy, rosy 
color in the face of the inhabitants of the highlands, the 
purest air is in constant regular contact with all the organs 
through the orifice of the mouth. Therefore, in checked 
perspiration, we find in activity and the reverse in in- 
flammation of single organs, a dry, parched, and even a 
burning hot skin ; in liver and bilious complaints, a yellow 
color of the surface ; after eating asparagus, musk, a simi- 
lar smell ; on taking cochineal, the reddish color of the skin, 
etc. But as it is a fact, which has not been known until 
lately : 1st, that the warmer the water used for bathing, 
the more weakening its effects upon the nerves ; 2d, that on 
the contrary, the fresh spring water as well by its own viv- 
ifying power, as through its freshness and the fixed air, which, 
in boiling, escapes in vapors or in bubbles, and by which the 
water is deprived of its carbonic acid, the really vivifying 
and refreshing principle produces upon the skin, by its 
contractive power, great vital activity, causes a reciprocal 
action, and with it a more rapid circulation of the blood 
and change of juices, wherefore, every one, who takes 



PREGNANCY. 21 

a cold bath or washes in cold water, first feels a degree of 
cold and afterwards an agreeable sensation of heat, the skin 
becomes red and appears fuller, whilst, when bathing in 
warm water, according to the degree of warmth, the skin 
first becomes red, the whole body warm or hot, nay, a rush 
of blood, congestion, and also fainting-fits occur, because 
the blood rushes back towards the larger vessels, the more 
important organs ; after the warm bath, the skin becomes 
wrinkled, pale, a chill comes on ;. persons who are so dis- 
posed have attacks of apoplexy, the blood not being able 
to return into the smaller vessels; 3d, that it protects 
pregnant women from rheumatism and its unhappy conse- 
quences ; and 4th, that an experience of many years has 
shown me that even women who were weak, who were 
ailing in different ways during their pregnancy, who could 
not bring children into the world without difficulty, re- 
quiring artificial help, who suffered from adhesion of the 
placenta, (after-birth,) hemorrhage, etc., after having ac- 
customed themselves for the cleaning of the skin, to wash 
in cold water, to use cold baths, and shower baths, did not 
only become again quite blooming, but were delivered from 
all their sufferings, before and during pregnancy, brought 
into the world without all artificial aid, healthy children, 
expelling the after birth without any manual interference, 
and without a return of the hemorrhages, we are obliged to 
admit the great healing power of cold water, also when 
applied during pregnancy. 

In consequence of the facts just mentioned, which may be 
verified by a number of examples, I cannot too earnestly re- 
commend to females, who are weak, hysterical, subject to 
miscarriages, uterine hemorrhages, (floodings,) to irregu- 
larity of the menses, etc., to accustom themselves to the use 
of cold water, and to continue it during pregnancy. 



22 PREGNANCY. 

Hereby the following directions should be observed : ac- 
cordingly as the patient is more or less hardened, or hei 
constitution is stronger or weaker, or subject to ailments, 
she should begin to wash first with warm water, and gra- 
dually accustom herself to use water colder and colder 
until she can bear pure spring water. 

But if the female is weak, afraid of the water, timid, let 
her begin to wash only her face and hands, then the breasts, 
and later, the whole body ; very w T eak and sensitive persons 
should roll themselves up, from the neck to the heels, in a 
large double sheet, which has been steeped in warm water, 
and allow themselves to be rubbed over the whole body by 
several persons at once. Here attention must be paid to 
the time, which in the beginning should be limited to half 
a minute, but which, after a continuation of six weeks, may 
be increased to five minutes. As the time is thus gradually 
increased, the temperature of the water should be decreased 
a degree every two days, until it reaches the natural degree 
of cold water. 

When a married or a single woman has once been ac- 
customed to wash her body every day, one way or the 
other, in water, the temperature of which is always lower 
than that of her skin, (a feat which is not very difficult 
w T hen once the commencement is made), she will herself be 
convinced of the vivifying and restorative qualities, by the 
increase of strength and the diminution of her suffering ; 
she will of herself progress in the application ; for every 
woman soon wants to become an "Undine,"* so much so 
that I have often been obliged to warn against exceeding 
the number of baths prescribed. From washing in cold 
water the patient may proceed to bathing in rivers ; the 



*A character in a novel, by Baron de la Motte Fouque. 



PREGNANCY. 23 

former, with ladies who have weak constitutions, should 
never last longer than five minutes ; the latter, only from 
ten to twenty minutes, and the whole body should be after- 
wards rubbed dry, with dry linen cloths ; particular attention 
also is necessary that no one enter the bath whilst heated 
or flushed, nor with a cold skin ; for only when the body is 
warm without determination of blood to the head, the cold 
bath can act beneficially. After the bath the person should 
dress immediately, and walk about until quite warm, then 
drink several glasses of water, particularly in the morning, 
but never eat until the body has recovered its usual warmth. 
Another precaution to be observed is, that no bath should 
be taken immediately after a meal, but that always one or 
more hours should be allowed to elapse. Generally the 
baths may be continued until one or two days before the 
commencement of the menses, the washing until they ap- 
pear ; and even whilst they continue, the head, face, breast 
and hands may be washed in cold water. 

Every woman therefore, who is in the family way, and 
who has not yet enured herself, in the manner just de- 
scribed, to the use of cold water, should try to do so be- 
cause it will be of infinite benefit to her, as well during the 
period of pregnancy, as at the time of delivery, for it will 
render her stronger, less subject to injurious influences, 
make the symptoms, which always appear during preg- 
nancy, milder, nay, perhaps prevent them altogether, make 
the labor easier and hasten the recovery ; the child will 
come into the world and have a fresh look; as already 
mentioned before, the often dangerous uterine hemorrhages, 
(flooding,) and the adhesion of the placenta (after-birth) 
will be prevented by the increased contractability of the 
uterus (womb), and the spontaneous expulsion of the after- 
birth be accelerated. 



24 PREGNANCY. 

A pregnant woman, who has not bathed as described 
above, may accustom herself, even during her pregnancy, to 
washing in cold water, and continue with it until the last 
moment ; but women who are already enured to the use of 
cold water, may, in summer, continue the use of the bath to 
within one-third of the termination of their pregnancy, but 
from that time until the day of the birth, proceed with 
washing thoroughly in cold water, particularly the breast, 
the abdomen, down to the knees. As constipation is very 
common with women, who are in the family way, a long 
and successful experience enables me to recommend, with 
confidence, daily, a hip-bath, of from five to six minutes dura- 
tion, and every second or third day, two or three injections of 
water, of the temperature of that, with which the patient 
washes ; also drinking freely of spring or hydrant water, 
of sweet, but particularly of sour milk. In case of a dis- 
charge from the vagina, fluor albus, (the whites,) besides 
the river-baths, these hip-baths taken in the fore and after- 
noon, and continued for half an hour, will be of infinite ser- 
vice ; the water for these baths must be of the temperature, 
to which the patient has already become enured. 

Respecting food, we often find that women who are with 
child, take an inexplicable dislike to many eatables, which 
are of themselves entirely harmless, or complain of incon- 
venience after they have eaten them. The principal rule 
of diet is moderation, and it would be well if every woman, 
under these circumstances, would strictly observe it, and eat 
only at fixed times, and without overloading her stomach, 
simply to satisfy the cravings of hunger. Among the 
things most injurious to a pregnant woman, and to the child 
which she bears, I place first : coffee, tea, spirituous liquors, 
and medicines. Coffee, which, as well as tea, has become, 
in our days, an indispensible requisite two or three times a 



PREGNANCY. 25 

day for the fair sex, and which even women who are in this 
condition, will not abandon, although they perceive them- 
selves the pernicious effects, produce under all circum- 
stances injurious consequences, and in particular, during this 
period of female life ; for its fine aroma, when the vital 
activity is already increased, causes rush of blood, morbid 
irritability, nervous excitement, and disturbance of the func- 
tions of the separate organs, leading as the use of spiri- 
tuous liquors, particularly punch and cordials, to an over- 
excitability, the symptoms of which the observer cannot 
fail to discover, and which are, that the formerly blooming 
healthy looking woman, with red cheeks, has of late become 
pale, that her skin grows white, yellowish ; that her spirits 
fail, that ill-humor, want of appetite, disorders of the 
stomach, hysterics, and constipation make their appear- 
ance, of which the worst consequences fall upon the child, 
as it will be ushered into the world, weakly, with a 
wrinkled, yellowish skin, dropsy in the head, and a dispo- 
sition to imbecility. Although numerous instances may be 
quoted, where the use of coffee and of spirituous liquors 
have not produced any perceptible bad effects, they cannot 
destroy the facts which we have obtained from observation, 
and which, every experienced accoucheur, physician, and 
father of a family, who has had an opportunity of observ- 
ing, will find true and confirmed, namely, that the said 
liquors, as well as the frequently taken medicines, exercise 
a pernicious influence upon the pregnancy itself, as well as 
upon the labor and upon the child. Not less do we recom- 
mend to each pregnant woman, to whom her own health 
and that of her child is dear, and to every husband, who 
cares for the life of either, to avoid all bleeding, not called 
for by a plethora, which suddenly threatens the life of 
the mother, and the more so, as women who wash in 

3 



26 PREGNANCY. 

cold water, or take cold baths, can never be placed in this 
situation. They retain their full and healthy breasts with 
sound nipples. 

Of the articles of food which it would be difficult for the 
pregnant woman to digest, I shall mention : asparagus, 
cellery, parseley, parsenips, all sorts of spices, particularly 
saffron and mace, also cabbage, black radish, all greasy 
food, particularly pork, geese and ducks, lemons, and cakes 
containing yeast. As wholesome, I should recommend as 
a beverage during this period, first, fresh water from the 
fountain or hydrant, cleared of all its impurities, and at its 
natural temperature, because, by its freshness and carbonic 
acid it animates the body, increases the circulation of the 
blood, improves digestion, and thus promotes the secretion 
of the milk. Weakly females, however, particularly after 
sickness may take with their dinner some good old wine in 
fresh water, and in the middle of summer, fresh water with 
orange-juice and sugar, ice of the same, also water with 
raspberry syrup. 

Game of all kinds, good beef, and full-grown veal, fowl 
and turkeys, fresh fish, spinage, white and yellow turnips, 
carrots, cauliflower, potatoes, and flour, prepared in a 
simple manner, without any spice, will furnish both mother 
and child with nutritive and wholesome food. 

The principal object of clothing is to protect the body 
against cold, and against the immediate rays of the sun. 
It might be made so as to obtain this double end, if fashion, 
the mania of our days, did not interfere and tyranize 
over us, and particularly over woman, from her earliest 
infancy. 

Too warm clothing prevents evaporation, and confines 
the nitrogen, which cannot escape, in the juices of the 
body, producing a diminished circulation of the blood and 



PREGNANCY. 27 

in the mass of the juices an acrimony, which ultimately 
causes diseases of the skin and other maladies ; it weans 
the skin, the natural covering of the body, and the body 
itself from the contact of the air, and renders it so delicate, 
that on the slighest occasion, an exposure to a draught of 
air, an attack of rheumatism or diseases of a graver nature 
must follow. 

But as too much clothing has an injurious effect upon the 
health, so also the insufficiency of the dresses of women, by 
which the neck, the shoulders and breast are exposed to the 
influence of the atmosphere, independent of all moral con- 
siderations, produce a mischievous effect upon the constitu- 
tion. We see women, who over a light stiff under gar- 
ment, wear nothing but a law T n dress, exposing themselves 
during the uncertain seasons of autumn and spring, and 
during the summer evenings, to every change of weather 
and to every draught of air. The skin is at such time in a 
contracted state, in which it is unable to perform any re- 
action ; hereby the circulation of the blood in the capilla- 
ry vessels of the skin is interrupted, and the same constantly 
driven back towards the centre ; thus the regular circula- 
tion is prevented, which produces a very injurious effect 
upon the health, particularly upon the glands and the de- 
velopment of the breasts. 

The greatest injury to woman, however, arises from con- 
fining the breasts and the body by stays and corsets, and 
from wearing bandages round the body, to be in fashion, 
without considering the accidents which after the slightest 
overheating, may occur, and without thinking, that with 
young girls, by this means, the growth of the breasts and 
the general development of the bust is prevented, producing 
sometimes the most disastrous consequences. 

Women who before marriage have followed this injurious 



28 PREGNANCY. 

fashion, should, when they become pregnant, pay parti- 
cular attention to this subject. By wearing stays, corsets, 
or bandages and pants, which are worn without braces, 
or shoulder-bands, the circulation of the blood is stopped, 
the functions of the bowels interfered with, breathing made 
difficult, which again causes rush of blood, palpitation of 
the heart, sickness of the stomach, interrupted digestion, 
convulsions, and fainting fits. Besides this, the abdomen, 
by being constantly confined, loses the power of the neces- 
sary expansion, whereby the bowels are pressed down- 
wards, and the development of the foetus is prevented. 
Besides the injurious effects produced upon the abdomen by 
lacing, the female breasts also suffer from this practice, be- 
cause it interferes with the slow conducting of the juices to 
the breast, a preparatory process, necessary for suckling, so 
that the vessels, which are to receive these juices, and the 
ducts, which serve for the secretion of the milk, cannot 
sufficiently expand and enlarge. 

In consequence of our every day sad experience, we 
would advise every mother, as soon as she feels herself 
pregnant, to arrange her clothing, so as to be fit for any 
season, without interfering with the expansion of the ab- 
domen or breasts, and without partially exposing the latter. 

It will be evident to every intelligent female, who reads 
this book, why I do not pursue this subject any further, 
and I shall only add that every pregnant woman should 
particularly keep her feet dry. 

Many women, when in the family way, are very fond of 
rest, but whatever their inclination may be, how much re- 
pose may be recommended by her relatives, their inclination 
and this advice should only be attended to so far, as to 
avoid too strong exertions of the body and of the mind, as 
just in the first months of pregnancy, exercise contributes 



PREGNANCY. 29 

to the health of the mother and to the development of the 
child. 

Pregnancy in itself induces languor and lassitude, where- 
fore pregnant women frequently feel inclination to sleep, to 
repose, in fact to be idle. Many yield to this inclina- 
tion, during the day, sleep frequently several hours after 
dinner, and spent the rest of the day in sweet idleness, in a 
state between sleeping and waking. From this source 
much unhappiness springs ; the house and the husband are 
neglected, and the foundation of discontent is laid. But 
this is not the only evil, which arises from this state of 
lethargy, it produces mental and physical disease, melan- 
choly succeeded by discontent ; indisposition succeeded by 
actual illness, and frequently by labor, which terminates 
fatally. 

Every young married woman should therefore attend to 
her domestic affairs, during her pregnancy, in the same 
manner as usual. Occupation makes the body healthy and 
cheers the mind. Yet, although her time be claimed by the 
management of her house, she should not neglect to take 
every day a walk in the open air, which must be considered 
as one of the rules to be observed during the time of preg- 
nancy. Women who have never had a miscarriage, and 
who have no sickness to contend with, may drive and 
dance, and when the latter is done, in moderation, even to 
the last hours ; for I have frequently had occasion to ob- 
serve, that just those women, who, up to the time of their 
confinement, took plenty exercise in the open air, had the 
easiest labor ; and I have even met with instances, where 
women who had previously lived a sedentary life, and had 
not been able to bring children into the world, without ar- 
tificial aid, have later, when they took plenty exercise in 
the open air, climbed hills, with moderation, and danced, 



30 THE MIDWIFE. 

had- an easy labor. But walking in the fresh air must be 
made an absolute rule, as driving is never so salutary. 
The other exercise, such as dancing and the climbing of hills, 
is intended as exceptions for strong and healthy individuals, 
and where the physician thinks it advisable. Weakly per- 
sons, who are disposed to hemorrhages, on the contrary, 
should during the first months of pregnancy, avoid riding, 
skipping, dancing, running, stretching, falling, constant low 
stooping, and lifting of heavy weights, for many a time a 
young married couple have been deprived of all their hoped 
for happiness, by the like imprudent conduct, of which 
every woman will have had an opportunity of hearing in- 
stances related, in the circle of her female acquaintances. 

As to conjugal intercouse during the time of pregnancy, 
a woman, otherwise healthy, ought to be very moderate, 
and during the last third of her time, should avoid it alto- 
gether. Weakly, irritable women, who are subject to ner- 
vous diseases, to miscarriages and to hemorrhages, should 
refrain entirely, from the time of conception during the 
whole period of pregnancy. 



THE MIDWIFE. 

There is nothing more to be regretted than the igno- 
rance of the midwives particularly of ours ; many mothers 
are sacrificed because they have never learned how to 
render the necessary assistance. 

THE FIRST RULE. 

A midwife, above all things, should be pious, chaste, sober, 
not daring, discreet, modest and experienced. 



THE MIDWIFE. 31 

She should be pious, that she might be afraid of punish- 
ment in laying hands upon the woman in labor, for the 
blessing of the Lord is not given to the wicked. 

She should be experienced ; and it would, no doubt, be 
better, if no woman were allowed to practice midwifery, 
without having made an examination as to her experience 
and scientific knowledge. 



SECOND RULE. 



She should, at least, have been present at the dissection 
of a female body, that she might know the construction 
and situation of the uterus (womb), and the vagina at the 
time, when there is no pregnancy. If she can be present 
at the dissection of a pregnant female, so much the better, 
as she will thereby obtain a more perfect idea of these 
parts. 

THIRD RULE. 

It is necessary for her to know how far a woman is gone 
in pregnancy, when the child begins to move, that is when 
the woman quickens, what is the natural position of the 
child, and at what time the labor is likely to begin. But, 
above all, she ought to be well acquainted with the symp- 
toms of pregnancy, so that she can distinguish a maid from 
a pregnant woman. It is not so easy to distinguish be- 
tween the suppression of the menses and a pregnancy, and 
between the latter and dropsy in the abdomen, for even 
physicians have treated women for dropsy until their child 
came into the w r orld. 

Most troublesome are those women who are in the family- 
way for the first time, and are ignorant of all the symp- 
toms of pregnancy, frequently deceiving their physician 



32 THE MIDWIFE. 

with their incorrect stories, when they take this or that 
slight movement for the motion of the child. This shows 
that we cannot immediately decide as to pregnancy, from one 
or two symptoms, but that we must connect them, and from 
the whole together, we may come to a proper conclusion. 
The principal symptoms of pregnancy are : 

1. The cheeks of pregnant women are mostly red, but 
not at all times ; the cheeks of those who suffer from sup- 
pressed menstruation are pale. 

2. With those, who suffer from the latter, we perceive 
around the private parts and at the orifice (mouth) of the 
womb a swelling, which with pregnant females is found 
higher up, towards the navel. 

3. Females in the family-way generally do not feel any 
diminution of strength, nor is the appetite so much affected 
as with those, who suffer from suppressed menstruation ; 
but this symptom is not quite reliable, because some fe- 
males at the time of pregnancy are much weaker than 
others. 

4. With the pregnant woman the veins begin to swell 
and become more perceptible, particularly on the thighs, 
which is not usual with others. 

5. The breasts swell ; but this is not always the case, 
many have no enlargement of the breasts, and yet are in 
the family- way. 

6. The urine is said to be thicker and clouded ; this 
symptom, however, is deceptive, nay, the most deceptive, 
as the same symptom is observed in many other diseases. 

7. With some the hips enlarge, with some not ; some 
carry the children more in front, some further back. 

8. Finally, we have the last and most infallible symp- 
tom, namely, the moving of the child, which generally 
takes place between the seventeenth and twentieth week. 



THE MIDWIFE. 33 

When we find this and the other circumstances corre- 
spond, we may be sure that a pregnancy exists. Sometimes 
it happens that this motion is not very perceptible until in 
the seventh month, particularly when the child is weak, in 
which case the abdomen should be externally rubbed with 
spirits, oil of mace, or nutmeg, which strengthens the child, 
so that the motion will be felt more distinctly. The same 
effect would not be produced if it arose from some swelling 
or flatulency. 

But it is not enough, that the midwife should know the 
symptoms of pregnancy, she ought also to be able to judge, 
whether an accouchment has lately taken place, which, at 
an examination, it is frequently necessary to ascertain. In 
this case, attention should be paid to what follows : 

1. After being delivered, the skin of the abdomen re- 
mains wrinkled, and does not immediately return to its 
natural state. 

2. If the delivery has taken place only a short time be- 
fore, the discharge of the blood, which is perceptible for 
six or eight weeks after confinement, though only in small 
quantities, is the surest sign. 

FOURTH RULE. 

The midwife should be well acquainted with all the inci- 
dents which may occur during an accouchment, and must 
know how to distinguish, with certainty, true labor pains 
from false ones. Much depends upon this, for an inexpe- 
rienced midwife frequently fatigues the patient too early, 
and before the time of delivery has really arrived, and, 
during false labor pains, urges her to exertions, so that 
when the time really comes, she is unable to make any. 



34 THE MIDWIFE. 

Real labor pains are contractions of the uterus (womb), 
which commence at the back and go downwards. The 
spurious or false pains, commence also at the back, 
but go upwards, and terminate about the navel ; at the 
time of these false pains, the woman should not make any 
exertion, the proper time should be allowed, and then a 
trifling compression of the abdomen will deliver the 
woman, for nature makes much greater efforts to expel the 
child, than the mother can make herself. Those who do 
not attend to the laws of nature, will never usher a child 
into the world, though they should employ every expedient 
and manipulation. The expulsion, without the effort of 
nature, is impossible. But when nature is prepared, it be- 
comes the duty of the midwife to examine, whether the 
child is in a proper position to be expelled, if the interior 
orifice of the uterus is open, which is to be ascertained by 
introducing two fingers, dipped in oil. When this is ascer- 
tained, the mother should be encouraged, she should be 
told not to let her breath escape, for fear of prolonging the 
labor. The patient may place her hands on the abdomen, 
in order to accelerate the expulsion somewhat. When the 
child is born, the midwife should tie the navel-string with 
a double waxed thread at the place where it is attached to 
the abdomen, and then separate the string, three fingers 
wide, over the ligature, she should now seize the navel- 
string, which is attached to the placenta (after-birth), give 
the child to the assistants and try to obtain the after-birth, 
the extremities of which, together with the navel-string, 
she will take in one hand, whilst, if necessary, she detaches 
it with the other. After she has obtained the after-birth, she 
should spread it out, so that every one may see that no part of 
it is left behind. For it is very dangerous if this occurs 



THE MIDWIFE. 35 

with the whole or part of iU In a village, in Upper Stiria, I 
witnessed the following case : — A woman, who had retained 
the placenta for four w T eeks after her delivery, was attacked 
by violent heat and convulsions ; after taking spirits of 
hartshorn, however, she fell into a great perspiration, and 
the after-birth was expelled, emitting the most horrid smell 
imaginable. Generally patients who meet with this misfor- 
tune, must die. When the child is born, and the after-birth 
expelled, a bandage should be placed round the abdomen, 
and the patient be put in a well-made bed, so that the dis- 
charge of the lochea (cleansing) go on properly. In the 
meantime, the child must be bathed and cleaned, how this 
is to be done, I shall mention hereafter. 

These directions will suffice in cases of easy labor. 

Difficult labor is of two kinds ; the one where the mother, 
the other where the child is the cause. In the former case 
w T e generally perceive a want of animal spirits, this want 
must be supplied by analeptics, and antispasmodics, as they 
are very necessary in difficult labor. The child is the cause, 
when its position is wrong, which arises from too much 
motion at the time of labor ; when the patient tosses from 
one side to the other, or when the proper time has not yet 
come, and the woman is urged to exert herself. Also, 
when a foot or an arm presents itself, which, if not pushed 
back very soon, will mortify, and w T il] have to be separated 
by the knife as soon as the mortification is really discovered. 
But, generally, the child dies in such difficult labor. The 
midwife must therefore be well informed, to decide whether 
the child is dead or not, that she may not kill a child which 
breathes very weakly, or, when it is already dead, delay too 
long, to the great danger of the mother. Sometimes the 
child must be divided by instruments, in the womb of the 



36 THE MIDWIFE. 

mother, and be extracted in pieces, which operation requires 
considerable firmness. 

It is known that the child is dead, when the patient is 
attacked with rigors and faints, when the face, and particu- 
larly the lips turn pale, when cold sweats make their ap- 
pearance, when the exterior parts are lead-colored, and 
when there is no motion in the womb, or when, on turning 
from one side to the other, it falls heavily like a stone, also 
when there is a very offensive discharge from the womb. 

Finally, the nurse ought to know whether there are 
twins, for it may easily occur, when both strive to escape 
from the womb, that she seizes one foot of each, think- 
ing there is but one child, or that she commits some other 
mistake. Although there are no certain and infallible signs 
of the existence of twins in the womb, we may yet suspect 
that it is so, when the abdomen is not every where equal, 
but is in some parts more elevated than in others, when a 
greater and unequal weight is felt, when the movement of 
the one is stronger and more lively than that of the other, 
and the motion is consequently perceived in two different 
places, either by the mother or by others. 

FIFTH RULE. 

The midwife should know, what is the womb, what a 
prolapse of the vagina, and what is to be done in such a 
case. The physician is seldom consulted on this subject, 
so that he might form an opinion whether it is a prolapse 
of the womb or a prolapse of the vagina. Eminent Doctors 
have argued differently, some maintaining that there could 
only be a prolapse of the vagina, others that there might 
also be a prolapse of the womb ; this was, however, not 
meant to be taken in its literal sense, and we should not im- 



LABOR. 37 

agine that a prolapse of the womb is impossible, nor should 
we think that the uterus is turned inside out, as we might 
turn a cap ; this would be ridiculous. But the remedies 
which are to be given internally, in a case of prolapse of 
the uterus, are mild tonics on account of the flaccidity of 
the ligaments. Properly speaking, the midwife ought also 
to know how to treat the patient under these circumstances, 
but I shall leave it to the physician. 

It is also the duty of the midwife to prevent the use of 
all superstitious remedies with females in confinement. 
There are many such known among old women, but I 
think it supurfluous to speak of them here. Some, in diffi- 
cult labor will advise the patient to put on her husband's 
stockings or a dirty shirt, others will give her his urine to 
drink, as if he bore the blame of all this ; again, others will 
tie round her body a belt of human skin, pretending it to 
be possessed of some peculiar potency, such and similar ap- 
plications the midwife should invariably oppose. 



LABOR. 

What does the man, who has never been called father, 
what the woman who has never borne a child, know of 
pains, of joy ? The sufferings at the time of giving birth 
are great, but the sight of the new-born babe makes the 
mother forget all, and fills her with delight most exquisite, 
she has given herself a child — to the world a man. 

At last, after much suffering, the long wished-for mo- 
ment approaches, when the mother is to be freed of the 
burthen, which, for nine months has reposed in her bosom, 
fed upon her blood, and grown into life ; at last the mo- 
ment approaches, which, to the mother, seems never to 



38 LABOR. 

come, for she longs for the time when she will press her 
child to a mother's bosom. 

When a woman is near the termination of that period, 
which is so all-important to her and to her child, we would 
advise her to cast another glance at the household, at the 
nursery room, and at her preparations for her confinement, 
and to make such arrangements, as may appear proper, 
that the young mother may not be worried by questions, 
during the very first days after her confinement. This is 
sometimes very improperly done, whilst the woman is in 
labor. 

As to the chamber, in which the woman is to be confined, 
it should be spacious, light, dry, and sunny, care being 
taken that the rays of the sun do not incommode the mo- 
ther or the child. The air in the room should be pure, 
wherefore it should be frequently ventilated, but in such a 
manner, that the mother and the child are not exposed to 
any draught, which can best be done by opening the win- 
dows of an adjacent room, for a couple of hours, whilst the 
door between that room and the nursery is kept shut ; then 
let the windows be shut and the communicating door be 
opened. All smells, odors, even scent should be banished 
from the room, coal gas from the stove or fire-place should 
be avoided, and no washing or scrubbing be done in the 
nursery. Let the temperature be moderate, and never ex- 
ceed 1 6° Reaumur, (68° Fahrenheit,) because too high a 
temperature is injurious to the mother and the child, where- 
fore there should be a thermometer in every nursery, near 
the window, to ascertain, at all times, the temperature of 
the room. 

The moment when the child begins to come forth from 
its covering, that is, from the ' membrane which lines the 
womb, is called the moment of delivery. This delivery has 



LABOR. 39 

a double object, the one to separate the child from the 
organs of formation, which have now become superfluous, 
and to conduct it to the outer w T orld, the place of its future 
existence ; the other to produce in the female body that 
change which is the beginning of a return to the state in 
which it was before conception. 

The change commences with the first stage of labor, and 
terminates when the child is weaned. The effort itself, by 
which nature expels the child, now capable of supporting life, 
together with the waters (liquor amnii,) the membranes, and 
the placenta, is called the birth of the child. But before this 
takes place we have several indications which inform us of 
the approaching labor, these are : the bearing-down of the 
child and the womb. We find the pit of the stomach as if 
empty, and the skin which covers this part, wrinkled ; the 
pelvis, on the contrary, is filled, and the abdomen sometimes 
projecting over it, whereby a peculiar dragging is produced 
in these parts and in the small of the back, which in the 
face of the patient shows itself by a prolongation of the fea- 
tures, so that she can frequently determine her approaching 
labor by the change in her countenance. A particular pres- 
sure is felt in the hips and the adjacent parts, which some- 
times becomes painful, and hinders the patient from walk- 
ing ; in consequence of which, urinating becomes difficult, 
constipation and heaviness of the bowels, and swelling in 
the lower extremities make their appearance. These, to- 
gether with a peculiar uneasiness, a fear and longing, never 
before experienced, a shuddering, running through all the 
limbs, and a mental and bodily lassitude are the real pre- 
cursors of approaching labor. 

The time is divided by physicians into four periods or 
stages, that of prognostication, of preparation, of actual 



40 LABOR. 

labor, and of expulsion, which latter is the real birth of the 
child. 

The period of prognostication begins by a drawing pain 
in the back, which is of short duration, and which extends 
towards the lower part of the abdomen and thighs, and fre- 
quently is not unlike the feeling which is experienced at the 
time of the first menses. When these pains increase in 
duration and intensity, when they are accompanied by per- 
spiration and fear, and a moisture is felt in the vagina, the 
preparatory labor-pains have commenced, which, as they 
increase effect the dilation of the mouth of the womb, (us 
uteri,) and which are assisted and promoted by the passing 
downward of the waters, (liquor amnii.) At this time a 
portion of the membranes of the ovum can on examination, 
be felt. 

These pains, just described, are of different duration, 
sometimes they last one hour, sometimes several, nay even 
from six to twelve, and in first labor, and with females ad- 
vanced in age, sometimes thirty hours. When the mem- 
branes are in this flaccid condition, a good pain finally breaks 
them, and with this the third period or stage begins. The 
waters (liquor amnii,) are discharged, though not always 
at once, because the two membranes of the ovum frequently 
appear still separated, and a considerable quantity of the 
false water (liquor allantoides) remains behind, which re- 
quires a second breaking of the membrane. 

After the discharge of the waters, a cessation in the pro- 
cess of delivery takes place, and a repose connected vtiih 
entire exhaustion succeeds ; the pains ceasing from half 
an hour to a whole hour. During this interval the walls 
of the womb press against the child, by which means a 
greater excitement is caused therein, inducing real labor 



LABOR. 41 

pains. At this period the part of the child presented, gen- 
erally the head, enters the mouth of the womb, (us uteri,) 
and descends deeper into the pelvis, whilst the mother cries 
aloud and suffers from pressure of urine and inclination to 
stool, frequently accompanied by vomiting, trembling, perspi- 
ration, faints. After the head has passed the orifice of the 
womb, it descends into the cavity of the pelvis, and this ter- 
minates the third period or stage of labor, the duration of 
which is sometimes only a few minutes, sometimes for want 
of pains, several hours. Here also an interval of repose 
generally ensues, after which the trembling pains succeed 
one another rapidly, and drive the head with a rotary mo- 
tion against the perineum. By this straining this part may 
be easily lacerated, if the midwife is not very careful. The 
best way to prevent this accident, is to support it by a roll 
of linen, or by the back of the shut fist. Now, the fourth 
period, that of expulsion has commenced. The pains are 
lasting, violent, accompanied by shocks and agitation, and 
the head or the breech passes through the orifice of the 
vagina, after which there is another respite or cessation of 
a minute or more, and then the rest of the child is expelled 
during another pain or two, but with much less suffering. 

As soon as the child is born, all pains and troubles are 
forgotten, and in most cases the mother feels perfectly 
happy at the sight of the child, which she longs to take in her 
arms. During this interval of from ten to thirty minutes, 
the womb begins to contract, descends until at last it can 
be felt like the fist of a man, over the pubis, and with one 
or more smaller pains separates from the so called after- 
birth, namely, the placenta, the membranes of the ovum, 
and the navel-string. That this is taking place, we may 
know from the appearance of a small quantity of blood in 
the vagina, which is discharged from the closing vessels of 

A* 



42 LABOR. 

the womb, and from those of the placenta at their separa- 
tion. This terminates the labor, and the mother feels weak 
and sleepy. 

During the time of labor the patient should have on a 
cap, shawl, night-gown, petticoat and stockings, she should 
avoid impatience, not try by premature pressing and forcing 
to increase and hasten the labor-pains, for this as well as 
all wanton screaming, restless conduct, and tossing about in 
the bed, deprives the patient of the strength so requisite in 
the later stages, and protracts the labor unnecessarily. But 
these are not the only bad consequences which result from 
it ; by impatience, lamentation, and useless prayer to be re- 
lieved from the pain, both the patient and those around be- 
come frightened ; it also induces the midwife to try to hasten 
the birth by her interference, which is never without evil 
consequences for the patient. 

Therefore every woman in labor should keep as quiet as 
possible, should slightly assist, by her own efforts the pains, 
and after each, remain perfectly still until new pains come 
on, at which time the nurse should assist the patient by 
holding her hands and her knees. In case the patient com- 
plains of thirst, she may drink cold water, as often as she 
pleases, but not too much at a time. If the patient is nerv- 
ous and feels faint, her face may be washed with cold water • 
if she suffers from headache, the nurse should put wet cloths 
on her forehead, which must be changed whenever they get 
warm. 

As soon as the midwife is aware that the time of labor is 
approaching, it is her duty to put every thing in order, that 
is requisite for the mother, whilst in labor, and for the child, 
after it is born. The manner of making the bed for the 
patient is, as follows : upon a common paillasse, place a 
straw, sea-weed, or hair-mattrass, over which spread a 



LABOR. 43 

common sheet, and upon this, at that part which will be 
occupied by the seat, a sheet doubled several times, which 
to save the mattrass, may be covered with an oil-cloth, the 
back should be supported by a sofa-cushion or something 
similar, and the head and breast be high and comfortable. 

Let the midwife attend to the different periods of labor, 
and avoid all hasty, manual, or medical interference. She 
should not try to assist the patient by giving her warm tea, 
camomile or nutmeg-tea, saffron or cinnamon tincture, and 
other mixtures ; for the like interference nature never 
suffers with impunity, the mother and the child feel the 
consequences. 

The midwife should confine herself to keeping the mind 
of the patient tranquil, to obtain for her comfort and quiet- 
ness, not to leave her, to make examinations from time to 
time, and to determine and regulate the commencing 
periods, according to the changes she has observed. 

If the midwife, on examination, finds something unusual, 
if the phenomena of labor, or the strength of the patient 
is such, that a favorable termination is doubtful, either re- 
specting the mother, the child, or both, she should demand 
an accoucheur, whom the patient or her relatives should 
select. When he arrives, it is his duty to attend inostenta- 
tiously, with proper regard to female delicacy, he should 
not be hurried, and by no means allow himself to be deter- 
mined upon bringing on forced labor, for experience 
teaches us that nature, if we allow her time, is able to 
perform enough, and much even in the most difficult cases. 
In cases of violent convulsions, of fainting fits, of pains 
with long intervals, or when suspended altogether, of too 
early or only partially separated after-birth, in partial ad- 
hesion of the after-birth, and the consequent flooding, and 
even where the use of instruments seemed unavoidable, f 



44 LABOR. 

have applied with the utmost success cold fomentations, by 
steeping a linen cloth, doubled four or six times, in fresh 
fountain or spring water, and placing it over the whole of 
the abdomen, changing it at intervals of from five to fifteen 
minutes, according to circumstances. Through the re- 
freshing power of the water, the nervous system of the 
patient is excited, through the frequent drinking of spring 
water and washing the face and chest with it, and through 
cold fomentation of the head, the convulsions and spasms, 
as well as the fainting fits are suppressed, and through the 
cold applications to the abdomen, a greater activity in the 
muscular fibres is produced in the womb, forcing the same 
to contract. By this means, the pains become stronger and 
more rapid, and an earlier delivery, and the separation of 
the placenta is effected. By continuing these cold fomen- 
tations of the abdomen after the child is born, which then 
ought to be extended to the knees, the strongest hemorr- 
hages of the uterus (floodings) will be stopped in the shortest 
possible time. 

When the child is born, the patient should be allowed 
to rest, for the body fatigued by the arduous struggle, which 
it is woman's duty to make, requires time to recover its 
strength. To prevent all dangers, particularly where there 
has been much hemorrhage, the patient should remain in 
the same bed, in which she has been delivered, only the 
pillow which supported her back, and the soiled linen should 
be removed, and something clean put in its place. When 
she has somewhat recovered, she may be brought carefully 
to another bed, which is to be kept in readiness for that 
purpose, and as a sweet recompense for all her sufferings, 
be allowed to press the new-born babe to her maternal 
bosom. 



THE CHILD-BED. 

When both the patient, and those around, her have acted, 
before and during labor, according to the dictates of 
nature, the confinement will pass over, without any trou- 
blesome casualties. 

The beverage of the patient should be cold water, which 
is the most suitable for herself and for her child. 

As to the food, it ought, for the first three or four days, 
consist of plain broth of lean meat, with groats, sago, rice, 
wheat bread, pearled barley, or egg and wheat flower, and 
of milk porridge ; only after the fourth or fifth day should 
the patient be allowed to take light meats, such as young 
chickens, stewed veal, etc., and preparations of flour, con- 
tinuing to avoid coffee, all sorts of vegetables and teas ; 
and not until after the expiration of ten days or a fortnight 
should she return to her usual diet. 

Although with the expulsion of the child and the after- 
birth from the womb, pregnancy and labor terminate, it lies 
in the nature of the case, and is not a mere habit or custom 
that the patient must remain, according to her constitution, 
from eight days to a fortnight in her bed, and from two to 
six weeks in her room. 

This time is necessary for the uterus, after its great expan- 
sion, to return to its natural size, for the w T ound caused by 
the separation of the placenta from that organ, to heal, and 
for the lochia to discontinue. The latter, commonly called 
the cleansings, is a discharge of lymph from the vessels 
which remained exposed, at the separation of the placenta, 
and ceases as soon as these vessels are closed, and the 
wound is healed. It is followed by a secretion of a puri- 

45 



46 THE CHILD-BED. 

form, white mucus, which, on account of the increased irril 
tability of the membranes and glands, continues until thej( 
return to their former natural state, which takes place in 
fortnight or later, according to the individual constitution 
of the patient. 

The midwife should see to it, that the parts are kept per- 
fectly clean, by washing in luke-warm water, and by a fre- 
quent change of linen. Washing in water of from 18° tc 
23° Reaumur (72J° to 83|° Fahrenheit), is particularly 
useful, not only as a means of cleanliness and invigoration, 
but also to increase the activity of the skin. I diminish 
the temperature of the water by degrees, until in the third 
and fourth week the mother can bear it, at 8° and 10° (50 
to 54|° Fahrenheit). After this, while continuing to lower 
the temperature, until it reaches that of spring or hydrant 
water, I order the abdomen and the parts, and afterwards 
the whole body to be bathed, a custom which every woman 
is glad to continue for the remainder of her life ; for she 
becomes accustomed to it, feels herself revived, strength- 
ened, less liable to be effected by injurious influences, as the 
result teaches ; she is stouter, looks fresher, and fairer. I 
can, therefore, not sufficiently recommend the fair sex to 
accustom themselves to wash in cold water, for experience 
has shown me that women, who had previously suffered 
from difficult labor, adhesion of the after-birth, flooding, and 
irregular menstruation, which had been either too copi- 
ous and too frequent, or too sparing, from whites (fluor 
albus), have, since they have accustomed themselves to 
washing their body in cold water, brought children into the 
world, not only without any difficulty or danger, but with 
ease, and have been entirely free from these complaints. 

As want of cleanliness, improper diet, too early leaving 
the bed, going out too soon, may have a bad effect, and 



THE CHILD-BED. 47 

also every violent emotion, particularly anger, may be in- 
jurious to the patient, we would advice every woman to 
avoid these, as much as possible, if she wishes to escape a 
prolonged sick-bed. 

When the nipples of the breast were sore or too small, 
the flow of milk insufficient, the breasts hard and painful, 
I have always made, successfully, cold application of a linen 
cloth, doubled four times, steeped in fresh spring water, 
wrung well, and placed over the whole breasts, over which 
I have put dry linen pads, which I changed as often as they 
became hot. 

For the last twenty- two years I have applied this remedy 
in all the cases that have occurred in my practice, and I 
have never found it to fail. 

THE LIFE OF THE NEW-BORN CHILD FROM THE FIRST 
MOMENT OF ITS EXISTENCE. 

Every animal organism passes, during regular stated 
periods, through a series of developments, prescribed by 
the laws of nature, and thus also the progressive and retro- 
gressive growth and existence of man is regulated. 

The foetus, in its covering, enclosed in the womb, appears 
different from the new-born child ; the life of this child be- 
fore teething, appears different from that after teething. 
What a difference between the age of the boy and that of 
the youth, between that of the man in his vigor, and 
that of the old man ; and how infinitely great is that change 
which shows us man first in his germ and afterwards in 
the pride of strength. All depends upon the development, 
which in a manner prescribed by nature, progresses irresist- 
ibly in each separate organic part, and in each period of 
life for itself, and in all and at the same time harmoniously 



48 THE LIFE OF THE INFANT, &C. 

and uniformly, which we ought not to oppose either by art 
or the folly of fashion in any way. Let us not imagine that 
we poor bunglers must come with a helping hand to assist 
nature in her work and to refine at it, when we cannot even 
comprehend her, cannot fathom her. 

The young scion comes out of his little world, the womb, 
among us, and the first effort, the cry by which he com- 
mences this epoch of development, is not to gladden the 
heart of his parents, or to announce his existence, nor the 
sound of complaint by which he wishes to express his pain ; 
but it is a sound which he utters in the effort and in conse- 
quence of the want of breathing the air. 

Breathing is most intimately connected with the prepara- 
tion and the circulation of blood, as by the expansion of 
the lungs the blood is conducted to them. The pulmonary 
artery, (artery of the lungs), namely, conducts from the right 
ventricle of the heart the blood in great masses to the lungs, 
whence the pulmonary vein conducts it back to the right 
auricle of the heart. By this deviation from the former 
circulation the heart is placed in its proper position, as dur- 
ing the time the ductus Botalli closes, the vein which passed 
from the portal vein to the inferior cava, becomes impassa- 
ble, and the foramen ovale lessens by degrees, until at last 
it fills up entirely. This alteration causes also, in the first 
period of the life of the babe, a considerable change, because 
it no longer receives, as in the foetal state, the blood through 
the umbilical vein, but through the portal vein. 

As soon as the first development of natural breathing has 
taken place, the attentive observer perceives how the child 
manifests its desire for the proper food, by the motion of 
the tongue and the lips. For although the organs of mas- 
tication are still undeveloped, those of swallowing or de- 
glutition are entirely formed. The secretion of saliva on the 



THE LIFE OF THE INFANT, &C. 49 

contrary, is very inconsiderable, and the stomach, which is 
still very small, can receive but little ; its muscular fibres 
are very weak, its sides or walls, as well as the intestines, 
thin ; it is filled with mucus, and wants the power to dis- 
solve the food, wherefore, digestion proceeds very slowly, 
and that organ, as well as the intestines, can only rid them- 
selves with difficulty of more solid masses. It would there- 
fore be improper to force the child to take the breast as 
soon as it is born, or to burthen its stomach, which is weak 
enough, with thick fat milk and slimy and sweet drinks. 
With a new-born child there is no difference between the 
thin and thick intestines, for besides being very vascular, 
(full of vessels), both kinds are very thin walled and filled 
with a dark-green tough mass, called meconium, for the 
discharge of which nothing should be done ; in case of ac- 
tual constipation, a bath or two each day will have the de- 
sired effect. As the intestinal canal progresses to perfec- 
tion, the liver remains behind, both in its growth and activity, 
wherefore in the grown subject, the latter is much smaller, 
paler in color and harder. The bile rushes abundantly to- 
wards the duodenum, and by its bitter fluid forces the whole 
surface of the intestines, as well as the membranes to con- 
tract, and thus to propel the contents onward. 

The kidneys and the bladder are very imperfectly de- 
veloped, the urine does not take the yellow color, and its 
peculiar odor, until in the fifth or seventh month. As to 
the system of generation, it is in the child, the same as in 
the foetus, entirely inactive, and does not reach its maturity 
until much later. 

The general character of the body, during infancy is 
more fluid than solid ; the solid parts are generally soft and 
delicate, the fat without substance, flabby. The develop- 
ment and activity of the muscles are still in the first stage, 

5 



50 THE LIFE OF THE INFANT, &C. 

and with the exception of those necessary for sucking, swal- 
lowing, crying, opening and shutting the mouth, which are 
immediately subject to the will of the new-born babe, they 
do not reach the proper degree of developement until very 
late. For this reason the child cannot hold up its head or 
retain the excrimentitious matter, it does not learn to walk 
until late, &c. Like the muscles, the bones, particularly the 
heads of the long or cylindrical ones, are not developed. 
As they consist of cartilage, do not afford any firm support 
to the muscles, and are soft and pliant, we see so many 
children whose limbs are bent, who have bow-legs ; the im- 
mediate cause of which is their having been held crooked in 
the arms of the nurse, and having been put to walk and 
stand too early. 

The blood of the child, as soon as it has breathed, be- 
comes considerably darker in its color, the vessels are more 
numerous, more expanded, and display greater activity, 
wherefore the pressure of the blood towards the capillary 
vessels of the skin is greatest during this epoch. This cause 
and the state of irritability, which is produced in the skin 
by coming in contact with the atmosphere, to which it has 
been unaccustomed heretofore, explains the color of car- 
mine or scarlet, in new-born infants. The nervous sys- 
tem, in proportion to the other systems, displays a consid- 
erable degree of activity, much more than in the later peri- 
ods, wherefore it is disposed to irregularities, is very sensitive 
and excitable. As on the contrary the brain is less devel- 
oped, as the ganglia are larger and the nerves stronger and 
because they, together with the brain, are soft and delicate, 
the organs of sensation are almost entirely inactive, and the 
child lives a sort of dreamy life. This delicate constitution 
of the nervous system, of the new-born child, easily ex- 
plains the strong impressions which external influences 



THE LIFE OF THE INFANT, &C. 51 

produce upon it, often becoming the cause of violent attacks, 
such as spasms, convulsions, cramps, inflammations, enlarge- 
ments, dropsy, ect. 

The skin, which at this period is still very loose, more 
delicate and porous than in grown persons, has a great 
abundance of nerves and vessels, and consequently a more 
animated vegetation, from which a disposition to frequent 
morbid secretions and corruptions may be expected. 

The glandulary system, finally, is that which is most de- 
veloped at the birth of the child, as we see in the Thymus- 
gland and the collateral nerves, wherefore in infancy a 
disposition to glandulous affections and scrophula, is com- 
mon. As in the separate systems, the difference between the 
life of a child and of an adult is apparent, so the same is 
not less observable in the dynamic relations, that is to say, 
in the three fundamental functions of the process of life, 
namely, the organic development and formation, (reproduc- 
tion,) the voluntary action of the muscles, (irritability,) and 
in the mental activity and self-consciousness, (sensibility.) 
The excitability in the child is often as strong as its power 
of action is weak and without volition, which accounts for 
frequent, sudden and violent illness of the child, which, a few 
hours before was quite well ; in the same manner, as in nature, 
we see a violent storm followed by a deceptive calm, we often 
see a violent attack of sickness succeeded by sudden relief, 
which is the result of the easy exhaustion of the strength of 
the child, and which, in similar cases, is but too often re- 
garded as a real improvement, until we are undeceived by 
the appearance of violent and dangerous symptoms. 

From the above described structure of the infant, my fair 
readers will perceive how much proper nursing is requisite 
for its future existence. Happy, therefore, the child, when 
judgment and capacity, added to patience and maternal af- 



52 THE FIRST CARE OF THE INFANT. 

fection, are united in the bosom of the mother, to protect it 
and guide it until grown up, until it fulfils its destiny. 

THE FIRST CARE OF THE INFANT. 

This consists in removing every thing, that may have a 
baneful influence upon the life or the health of the child, 
and in procuring every thing requisite, that the necessary 
growth of the child's organism may advance to maturity, 
without being disturbed. Our attention should therefore 
be first directed to the circulation of the blood, every me- 
chanical obstacle which might disturb this function, should 
be removed with all possible diligence, the air in the nur- 
sery should be pure and wholesome, the mouth and nostrils 
of the infant should be freed carefully, with the finger, of 
their foreign contents, such as phlegm and blood. If the 
navel-string is round the neck, it should be disengaged as 
quickly as possible, and if that cannot be done immediately, 
it should be cut. If with weak premature children, although 
the mouth and nostrils have been voided of their contents 
and the navel-string has been disengaged, respiration does 
not commence, place the child, as soon as possible, into a 
tepid bath of 24° to 27° Reaumur (86° to 92 j° Fahren- 
heit), apply friction whilst in it, pour water in short gushes 
over the head and breast, and direct to the same parts a 
small stream of water ; as soon as the child breathes, put it 
in warm cloths. 

In cases where, after difficult labor, or from other causes 
the child comes into the world apparently dead, we should 
distinguish whether it is a mere faint or apoplexy. We 
may suspect a faint, when the mother before, during or 
after labor, has lost much blood, when the child itself, by a 
laceration or tearing of the navel-string has lost any blood, 



THE FIRST CARE OF THE INFANT. 53 

if it lived for some time after it came into the world, and 
ceased to breath afterwards from exhaustion. In this case 
the face as well as the w T hole body appears pale and the lips 
blue, and the navel-string should not be tied, but the child 
must be wrapped in warm cloths and be left in the lap of 
the mother until the after-birth has separated ; if then respi- 
ration has not returned, or if the after-birth was expelled 
with the child at the same time, let the child, together with 
the after- birth, be placed into a tepid bath of from 18° to 
20° Reaumur (72$° to 77° Fahrenheit), and the head, 
breast, and limbs be sprinkled with cold water until return- 
ing life manifests itself by jerks, tremulous motion around 
the mouth, returning heat in the body, redness of the lips, 
pulsation of the heart, and finally respiration recommences 
and rewards us for our trouble. After this let the child be 
wrapped in warm cloths, and place it on the side of the 
mother. 

If through some mechanical cause, or other injurious in- 
fluence, the child, during difficult labor, is attacked by apo- 
plexy, the symptoms cannot be mistaken. 

The whole face of the infant is very red or bluish red, or 
even black, the eyes project from their sockets ; the body 
is hot, dark-red, or here and there covered with blue spots, 
and the skin is stretched and dry, the umbilical vessels are 
congested with blood, in which, not unfrequently, pulsation 
is almost visible ; in most cases of this kind, the children 
are large, strong, and fully grown. To counteract quickly 
the suspension of circulation, which has here taken place, 
we should give it vent ; in this case, this is most easily 
effected, by diminishing the quantity of the blood. Let the 
navel-string be cut as quickly as possible, and in cases, 
threatening danger, let a small tablespoonful of blood es- 
cape from that part, which adheres to the child, whereby 



54 THE FIRST CARE OF THE INFANT. 

both the degree of undue fulness of the blood, and the 
bodily constitution of the child is to be taken into conside- 
ration. As soon as one respiration is perceived, the navel- 
string should be tied in the proper place, three or four fin- 
gers' breadth from the belly of the child. Of essential 
service, are, in this case, cold eifusions over head and 
breast, by means of a small watering pot. But, if respi- 
ration should not ensue, then place the child into a very 
cold bath, up to the middle of the chest, pour water over 
the head in the manner described above, rub the breast and 
limbs well, excite the gullet, with a feather to cause vomit- 
ing, to remove the phlegm, that might perhaps have accu- 
mulated in the nostrils, and breathe into the mouth and 
nostrils of the child, but very carefully. If animation re- 
turns, which appears in the muscular motions, breathing or 
crying-out, wrap the child in dry, moderately warm cloths. 
But if breathing after a while becomes weaker again, if the 
face resumes the dark-red color, replace the child into the 
cold bath, renew the former operations, without letting 
blood, until the attack is passed. 

As soon as the child is born and the navel-string is separa- 
ted, let it be the first duty of the midwife or nurse to clean the 
child of the cheesy coating of mucus and blood with which 
it is covered, by putting it in a bath, the temperature of which 
must not exceed 24° Reaumur (86° Fahrenheit), although 
later it must be diminished, of which more hereafter. This 
bath must last from fifteen to twenty minutes. Wash with 
a soft bathing-sponge first the eyes, and then the body 
lightly, in doing which the child should be supported in the 
bath in such a manner, that the hand is under the shoulders, 
and that the head rests upon the fore-arm of the nurse. Nur- 
ses and mothers are here particularly warned not to use the 
sponge, with which the cheesy coating of the body has been 



THE FIRST CARE OF THE INFANT. 55 

removed, in washing the eyes afterwards, for experience 
teaches us that this often produces very dangerous inflam- 
mations of the eyes, to which new-born children are liable. 
After the child has been washed, and the cavities, such as 
the eyes, mouth, nostrils and anus have been cleaned of the 
phlegm, the nurse should examine the child whether it has 
not received some injury during labor, whether none of the 
natural apertures are closed, or whether there is not some 
malformation. When she has satisfied herself in this re- 
spect, let the child be wrapped in dry clothes, and without 
further uncovering it, be placed along side of the mother. 
Later, after the first rest, the child should be washed, and 
lightly swathed and dressed, which ought to be done 
quickly, without losing any time with hugging and fondling 
the infant. When clean and dressed, present it a second 
time to the mother, who may now put it to the breast, 
wiiereby the mucus that may still be adhering to the throat, 
will be best removed. If the mother is sickly, and still 
exhausted from labor, let her lay on her side, and in this 
position give the child the breast. 

Many mothers, or so called famous nurses, imagine that 
the child must be purged, and give it, before placing it on 
the breast, fennel, anniseed, camomile-tea, or syrup of manna, 
tincture of rhubarb, etc., and thus prepare pain and discom- 
fort for the poor infant, that has scarcely perceived the light 
of this world. Every one ought to discountenance the like 
remedies, and take care not to injure the child by such 
quackery, customs, and superstition, the consequences of 
which, to the health and constitution of the child, are 
sometimes most distressing. 



THE FIRST CRY. 

As we have already mentioned in the preceding chapter, 
the first cry of the child is, in consequence of its efforts to 
obtain fresh air, which enters the lungs and the empty cells, 
extending them and forcing the lungs by the irritation to 
inhale and exhale. This cry lasts until all the air-cells are 
capable of respiration, producing the expansion of the 
lobes of the lungs, which before the birth, were closely 
compressed, opens the chest sufficiently, and thus forces the 
blood from the anterior venticle of the -heart into and 
through the lungs. We should, therefore, not try to stop 
the first cry of the child, by turning, fondling, or rocking 
it, or, perhaps, slapping it behind, etc., as this might 
prove very injurious for its respiratory organs. This first 
cry, which is accompanied by a heightened red color, by 
opening the nostrils and the mouth, by the motion of the 
hands and feet, differs from the succeeding, in com- 
mencing by short, jerking sounds, which grow longer and 
longer, and terminate in a full, clear sounding scream, 
during which not a tear is ever visible in the eye of the 
child, and which is never accompanied by an echo or sob- 
bing ; the child much fatigued, soon closes its eyes. Soon 
after, the crying commences again, and this second cry- 
differs perceptibly from the first, and is forced from the 
infant by the unaccustomed contact of the surface of its 
body, with the atmosphere of the room, by the light, by 
the handling, and by the bath. Now, the scream is a 
shrill cry of three to four successive jerks, which is fol- 
lowed by an echo or a much longer scream, not unlike the 
bleating of a sheep. Here, we should try, if we can do 
56 



THE SUCKLING OF THE CHILD. 57 

any thing, if perhaps the light in the room is too strong, if 
the bath is too cold, or worse, too warm, if the clothing is 
too rough or too tight, if the child is swathed too tightly, 
or is in an improper position. 



THE SUCKLING OF THE CHILD. 

Woman, whose noble destiny it is to supply with food, 
the child, which she has carried for ten months in her 
bosom, during which time it has drawn its sustenance from 
her juices, until its digestive organs shall be sufficiently 
developed, feels, as mother, a natural desire of performing 
this important duty herself, and not to leave it to a merce- 
nary stranger. For nature, which had supplied her with 
peculiar organs for this purpose, inspired her with maternal 
love, and with a feeling of pleasure to feed the babe at her 
own breast. What woman, who has ever nursed a child, 
will deny that just that feeling is the reward of all the suf- 
ferings she has endured, and all the duties she has fulfilled 
during this period ? As soon as the first period of preg- 
nancy commences, the female bosom begins to fill, to ex- 
pand, the nipples become larger, the otherwise pale-red 
areola becomes deep red, and frequently a milky fluid 
exudes from the breast. All these indications of future 
capability of suckling, increase, as pregnancy advances, and 
disappear as rapidly, if by a miscarriage, the child, inca- 
pable of supporting life, dies prematurely. These are 
proofs that the functions of the breasts are in harmony with 
those of the organs of child bearing, and that the milk of 
the mother resembles most the food, which has supported 
the child before its birth. 

Already at the first interval of repose, which the patient 



58 THE SUCKLING OF THE CHILD. 

enjoys after the child is born, the breasts commence to feel 
tight on account of the rush of the juices in these parts, for 
when the child is born the functions of the uterus cease, and 
the flow of the juices is diverted from that organ to the 
breasts. 

When the mother is in good health, she feels immediately 
disposed to give her child the breast, which may be allowed, 
as soon as the child is cleaned and dressed. When the 
tightness is in proportion with the filling of the breast, the 
mother experiences a sweet feeling of comfort, which, with 
proper management will be lasting. 

If, on the contrary, the duty, which nature has imposed 
upon the mother, namely, that of suckling her infant, from 
vanity, rage for public amusements and entertainments, from 
ignorance or the ridiculous, unfounded belief that nursing 
brings on premature old age, or from intentional neglect of 
the first duties of the mother, is deferred or entirely aban- 
doned, then, swelling and hardening of the breasts, milk 
and other fevers make their appearances, and these are gen- 
erally accompanied by interruptions in the progress of con- 
valescence, principally of the lochia, and other untow T ard 
symptoms, which unfortunately produce the most distressing 
effects. The number of cases where young, robust mothers, 
who had not suckled their children at all, or had weaned 
them suddenly, have lost their lives or become idiots, not- 
withstanding the utmost medical attention, is immense. 
When, with women who do not know the sweet feeling, 
which the mother experiences, in suckling her babe herself, 
one pregnancy follows close upon the other, and the milk 
which is secreted, is not withdrawn, a disturbance in the 
functions of the glands of the breast and of the lacteal ves- 
sels ensues, which diverts the whole force of production from 
this organ to the uterus, in which, in consequence of this 



THE SUCKLING OF THE CHILD. 59 

uninterrupted labor, there arises a morbid activity, which 
leads either to entire inertness, or to hysteric affections, 
(nervous irritability), to flooding or to leucorrhoea, (the 
whites), or to tedious inflammation ; if this occurs in individ- 
uals who have a secret predisposition to disease, or who 
indulge in excesses, it terminates in tumors, such as wens, 
polypi, indurations, or cancerous affections. These evils, 
whether they come early or late, when once they exist, no 
physician can cure, and therefore, we see but too often, par- 
ticularly in the higher classes, young women fade away, 
who, although nothing is spared to save them, find relief 
only in a premature death. 

Oh, that mothers, therefore, would take advice, and fulfil 
this holy duty which Providence has assigned to them ! 
that they would nurse their own infants ! How much pain 
and trouble would they save themselves and their child. 

Experience teaches us most incontrovertibly, that the 
generally prevailing opinion, that the charms of the mother 
fade earlier, that the fullness and beauty of her proportions 
disappear sooner, when she suckled her infant on her own 
bosom, is without any foundation, is a mere invention of 
vanity ; for women who do not suckle their children pre- 
serve their beauty no longer than those who do. 

Are not beauty of face and fulness of form perishable gifts, 
the continuation of which depends upon the constitution, 
upon sickness, upon disposition to disease, upon fortune, 
upon conjugal happiness or misery, and upon the change- 
fulness of human life ? Do we not find numerous instances 
among the lower classes, where the majority of the women, 
who suckle their children are at an advanced age healthy, 
buxom, and, considering their years, may still be called 
handsome ! What signify single instances against so many 



60 THE SUCKLING OF THE CHILD. 

proofs, against all the evil consequences of the neglect of 
this holy maternal duty ! 

Let us suppose, however, this injurious illusion to be true ; 
let us suppose that the mother, in the fulfilment of her duty, 
had to pay her tribute to nature, by losing her charms a 
few years earlier, she would yet owe it to herself, her child, 
her family, to the dictates of morality to fulfil that duty. 
She owes it even to the State, of which she is a citizen, to her 
country, which has a right to expect from her, that she 
should endeavor to the utmost of her power, to bestow 
strength upon her offspring, and not to burthen society with 
cripples, weak in body and mind. 

Women who suckle their own children are looked upon 
with more respect ; the love, the affection of their husband 
increases and thus their conjugal life and domestic happiness 
is promoted. 

In an inverse proportion, as the omission of suckling the 
child is injurious to the mother, so is the receiving of the 
pure milk from the mother's breast advantageous to the 
child. As soon as the mother has somewhat recovered from 
the fatigue of labor, and when the child has been bathed 
and dressed, let her enter with patience, love, joy and hope 
upon the fulfilment of the great duty, the suckling of her 
lately born child. But before putting the child to the 
breast, it is the duty of the midwife, to take care that the 
breast of the mother be washed with luke-warm water, and 
the nipples be moistened ; which latter the midwife can do 
best, by rubbing them forward, with the tops of two 
fingers. And now the mother may put the child to the 
breast, which, for the first three days had better be per- 
formed whilst lying on her side. But it happens not un- 
frequently, particularly with the first child, that the babe 



THE SUCKLING OF THE CHILD. 61 

will not take the breast, at which, the mother should not 
become alarmed, for either, there is not yet sufficient milk 
in the breast, or the nipples are not yet prepared for 
the operation ; or the child is weak, or is perhaps what 
is called tongue-tied. In the first case the mother should 
patiently wait until the quantity increases, and in the mean- 
time give the child a drink of half milk and half water, with 
a little sugar. 

Nature, in her wisdom, has here also made a provision 
that the mother, exhausted by her exertions, should not be 
too much troubled by the child and gain time to recover ; 
for the little stranger, generally, sleeps away the first days 
of his existence. When the nipples are not yet in a proper 
state for suckling, the mother should frequently put the 
child to the breast, though not too often, that the nipples 
may become longer and larger. If the child is weak, let 
the mother wait until it recovers, which will soon take 
place. 

If there is more milk in the breasts, than the child can 
suck, the best thing is, to rub the nipples with the moist 
fingers, and to put upon the breast, cloths doubled several 
times and warmed in the bed ; these should be changed as 
often as they are damp. But in spite of all possible pre- 
caution, the business of suckling does not always succeed 
entirely to our satisfaction, and without pain. Sometimes 
ihe child will suddenly start back from the breast, drawing 
its lips rapidly over the nipples, "and causing the mother a 
piercing pain, which is also felt in consequence of the child 
leaving off too frequently. 

When the nipples are small, and the child takes them be- 
tween the lips and draws them in, a violent pain that pene- 
trates into the breast, is felt, which seems to be insupporta- 
ble to the mother, who, if she is not firmly leaning against 

6 



62 THE SUCKLING OF THE CHILD. 

something, will involuntarily start back, and thus tear the 
nipple out of the infant's mouth. This frightens the child, 
it screams and becomes impatient ; the mother pities it and 
scarcely is the worst of the pain past, when she puts the 
child again to the breast, and the just described scene is 
renewed. By this sudden withdrawing of the nipples, if 
) repeated often, they become sensitive and crack. The 
outer-skin also becomes very sensitive, and if notwithstand- 
ing, new attempts at suckling are made, without allowing 
the pain and sensitiveness to pass away patiently, the nip- 
ples will get red and sore ; they, as also the breast, will be- 
come hot, and if the attempts are continued, or, in order to 
get rid of the superabundant milk, use is made of nipple- 
glasses, the irritation increases the pains, the milk comes in 
small quantities, and appears thin and cloudy. The breast 
becomes hard, knotty, (full of lumps), with a feeling of 
pressure, which condition, if neglected, may lead to the 
worst consequences. 

When the breast is already in this condition, it should, on 
no account, be given any more to the infant, because it 
will not only make it impatient, but may cause real sick- 
ness. The best thing is, not to listen to any old woman's 
advice, on this subject, but to send at once for an expe- 
rienced physician. 

The best means that I know to prevent this evil, is, that 
the mother must, however difficult and painful it may fye, 
leave the child on the breast until it ceases to suck. To 
effect this, she should lean with her back firmly against 
something, and softly press the head of the child with the 
flat of the hand against her breast. She will find, that as 
soon as the child is sucking freely, the pain ceases, with 
the exception of a few short stitches, which become weaker 
every time. And she will succeed the sooner, if she allows 



THE SUCKLING OF THE CHILD. 63 

a considerable time to elapse, after the child has been 
sucking, and in case the nipples are cracked, painful, or in- 
flamed, if she place over them and the areola, compresses, 
the size of the palm of the hand, of fine old linen, which have 
been dipped in lukewarm water and been slightly wrung, 
and over these, dry compresses (pads). These compresses 
must be changed as often as they commence to get dry. 
But if the breast looks blackish, is hard, and feels knotty, 
put over the whole breast linen rags, four times doubled, 
and well wrung out; as soon as they are dry, let them be 
changed until the pain and hardness disappear. 

This remedy I have always found attended with the best 
success, even where the swelling, hardness and pain were 
very considerable, the milk had failed entirely, and ulcers 
had made their appearance. In a short time the breasts 
healed, a sufficient quantity of good milk was produced, and 
the mother was well and hearty. But whilst she is sick, 
strict attention to diet is necessary, and she must be parti- 
cular, to keep the compresses, which are over the wet 
cloths, constantly dry. 

The above simple treatment of this kind of sore breasts, 
I can recommend most conscientiously, having tested it, and 
convinced myself that it is most judicious. At the same 
time I cannot repeat too often to young girls and young 
mothers to beware of stays and corsets. This fashionable 
folly is one of the first causes, perhaps the principal one, 
that young mothers suffer from small nipples, sore breasts, 
their late development, slow secretion, and bad quality of 
the milk. Therefore no woman,, particularly after the com- 
mencement of pregnancy, should put on stays or corsets, 
or otherwise confine the breasts. 

When the time, which is generally considered proper for 
a mother to remain in bed, has passed away without any 



b4 THE SUCKLING OF THE CHILD. 

accidents, she should, in the beginning, spend a few hours 
a day out of bed, and return only gradually to her usual 
occupations. This precaution should be used, even if the 
mother feels sufficiently strong, because the body, which 
has suffered much, is still very sensitive and irritable. Par- 
ticularly she ought to guard against taking cold, as during 
the first days she will be very liable to do so. 

As to diet, it is also necessary to be very cautious, not 
only during the period of confinement, but during the whole 
time of suckling. Every woman who is pregnant or nursing 
should refrain from every sort of spirituous liquor, of 
spicy, sharp, hot, salted and preserved meats, of salt or 
pickled fish, of coffee and tea of all kinds, particularly 
of Chinese tea, of elder tea and the like, because they 
have a bad effect upon the secretion of the milk, and con- 
sequently upon the health of the child. 

Every woman who suckles, should also avoid excess of 
mental application and all violent emotions. She should 
be very particular as to the cleanliness of the skin, as this 
has great influence upon the secretion of the milk as also 
upon the lochia (cleansings), we therefore repeat, that 
w T ashing or bathing from five to ten minutes at a tempera- 
ture of from 24° to 26° Reaumur (86° to 90 J° Fahrenheit), 
cannot be too urgently recommended. The temperature of 
these baths, as has already been observed, must be gra- 
dually diminished. 

Although there still exists an opinion, and particularly in 
this country, that a woman should not leave her room for 
six weeks, my experience authorizes me to recommend fresh 
air, before the expiration of that period, particularly during 
the summer months. When she goes out for the first time, 
however, she should select fine, and, if possible, warm and 
calm days, should dress according to the season and tempe- 



THE NURSE. 65 

rature, and avoid exposing herself to a draught. Although 
I would warn every woman against wearing flannel, canton 
flannel, or lamb's skins, upon her breasts, yet she should 
protect them against cold by appropriate clothing, and alto- 
gether guard against dressing too lightly, as this, but too 
frequently, is the cause of serious maladies. 



THE NURSE. 

Although it is natural for every mother, and Provi- 
dence has imposed it upon her as a most pleasant duty, to 
suckle her child herself, yet there are cases which form an 
exception to this rule. But even in these cases, if there is 
no actual impossibility of suckling, I would recommend 
every accoucheur, every midwife, and every one who has 
any influence upon a woman in this situation, to induce her 
to suckle her child herself, if it be only for a week or fort- 
night ; for, by this means, many of the dangers of child-bed 
are avoided, to which mothers, who refuse suckling their 
children, are exposed. 

But this ought not to be the only motive for a mother to 
suckle her child ; for even if no physical suffering should 
result from the non-fulfilment of this duty, she will not 
escape the reproach of her conscience for this neglect. 
Frequently such mothers find afterwards, to their sorrow, 
that their children treat them with coldness, and always 
prefer the nurse or foster-mother. A child must naturally 
imagine, that the person who suckles and nurses it, is its 
real mother. This love for the nurse, which it has imbibed 
with the milk, often continues to the grave, a circumstance 
which constantly galls the feelings of the mother. 

Cases where a mother cannot suckle her child are : ex- 
6* 



66 THE NURSE. 

cessive weakness, nervousness of the mother, many kinds 
of diseases., of which it is to be feared, that they may be 
transmitted to the child by the medium of the milk ; sore, 
diseased, or festering breasts and nipples ; entire absence or 
bad quality of the milk, and finally, incapacity in the child 
to take the breast of the mother. 

In cases where the mother is really incapable of suckling 
the child, and as the milk of a woman always remains the 
best and lightest food for a new-born child, it becomes ne- 
cessary to substitute the milk of a nurse for that of the 
mother. But as the nurse exercises a very considerable in- 
fluence as well upon the physical as upon the moral consti- 
tution of the child, parents can never be cautious enough 
in the selection of the individual. Above all, they should 
look to a pure, moral character, should not rely upon mere 
hearsay, but demand authentic proofs, and have recourse 
either to the family physician or some other reliable friend 
to make inquiries, and, satisfied on this head, they should 
assure themselves that she has no bodily defect, but is in 
perfect health. Her age ought to be as nearly as possible, 
corresponding with that of the mother, and when such a 
person cannot be found, the preference should be given to a 
woman between the age of eighteen and of thirty-six, whose 
constitution and temper, resembles that of the mother as 
much as possible. Another desirable point is, that the con- 
finement of the nurse and of the mother should have occur- 
red, as nearly as possible, at the same time, so that the 
existing difference between those juices, which have sus- 
tained the foetus, and those which are to feed the child, may 
not be increased by the long interval between the delivery 
of the mother and that of the nurse. Nor ought the nurse 
ever to have had more than two children ; her milk must 
be healthy and in sufficient quantity, and she herself must 



THE NURSE. 67 

not be married. To be convinced that a woman possesses 
all these qualities, a person should be a physician himself, 
as he alone is capable of making these examinations and 
inquiries. The signs of a perfectly sound nurse, are as fol- 
lows : a fresh and youthful appearance, a rosy complexion, 
lively, sparkling eyes, a healthy and perfectly pure breath, 
dark-red lips, without being chapped or sore, clean, white 
teeth ; full, firm and rounded breasts, sound, projecting nip- 
ples, without sore or chap, and forms well rounded and 
lusty. If, therefore, persons are necessitated to make a 
selection of this kind, they will do well to consult an intel- 
ligent, upright, and conscientious physician. 

Of no less consequence is it to pay attention to the temper 
of the nurse, because the child is not only apt, with the 
milk, to imbibe also the passions of the nurse, but every 
strong reaction of the mind diminishes the milk in its quan- 
tity and changes its quality. This change often produces 
sickness of the stomach, retching, diarrhoea, cholic, convul- 
sions, spasms, &c. Therefore it is necessary to see that 
she possesses a tranquil mind, not fretful, not given to amuse- 
ments and pleasures, not fond of flirtation and free of 
jealousy. 

The milk is good, when it is neither too thick nor too 
thin, more watery then consistent, when its color is bluish- 
white, when it is free of all taste and smell, when it runs 
off quickly from an inclined china plate, when, after being 
poured into water, it forms a light cloud, and after it has 
stood a while does not make too much cream. If we wish 
to be certain as to the nutritive power of the milk of a 
nurse, we should look at her child, and from its appearance, 
if healthy and blooming, or thin or emaciated, we may with 
confidence judge of the quality of the milk of the mother. 
As the suckling of the child influences both the present and 



68 THE NURSE. 

future state of its health, we can never sufficiently impress 
upon her mind the importance of her charge and interest 
both her heart and her conscience in the fulfilment of the 
duties she has undertaken. We should therefore explain to 
every nurse, as soon as she enters upon her service, exactly 
what she has to do and what not to do. As people are in 
the habit of allowing the nurse many advantages and treat- 
ing her with great indulgence, it frequently happens that in 
consequence of the great importance, which is attached to 
her services, she is led to abuse the goodness of her mis- 
tress, and not only to make too free, but even to conduct 
herself, domineeringly and arrogantly. It is therefore ne- 
cessary to allow the nurse no striking privileges, but to 
employ her at times, when she is not engaged with the 
baby, in such domestic occupation, as she is capable of per- 
forming. Such occupation is wholesome both for nurse and 
child. Most nurses belong to the working classes, and are 
accustomed to be occupied with some manual labor, from 
morning until night ; when such a person is suddenly al- 
lowed to remain idle, becomes accustomed to rich meats, 
perhaps to spirituous liquors, the natural consequence must 
be, that the circulation of the blood is diminished, which 
soon produces a very injurious effect upon her own health 
and that of the child. 

What trouble, however, we may take, in selecting a nurse 
and preserving her from all injurious influences, she never 
will and never can entirely supply the place of the mother. 
We certainly cannot expect from a nurse, out of love for 
the baby, which is a stranger to her, that suppression of all 
violent emotion, that equanimity, that love and care in nurs- 
ing, and uncultivated herself, that capacity of fostering the 
mental powers, as they begin to unfold themselves, which 
we should expect from a mother. Has not the fact of her 



THE NURSE. 69 

misfortune already irritated her mind ? Does not grief gnaw 
her soul, that she is obliged to leave her own child to the 
care of strangers. But suppose her mind to be perfectly 
free from all scruples of conscience, is not that a sure sign 
of great depravity, and should we not have cause to fear her 
thoughtlessness, her want of affection. But suppose the 
qualities of the chosen nurse to be all that is praiseworthy, 
the child at any rate is deprived of the advantages, which 
it would have obtained with the mother's milk. 

From all that has been said, it will appear evident that 
the mother of the child, particularly in the beginning, 
should keep a watchful eye upon the conduct of the nurse. 
Order in suckling, proper and punctual attendance, constant 
cleanliness of the child and every thing about it, are the 
principal objects, to which she ought to direct her attention. 
The mother should also try, by quietly observing her, if the 
nurse manifests love and assiduity in her conduct, or whether 
she shows repugnance towards the child, she suckles ; she 
should observe her watchfulness at night, and the manner in 
which, during that time, she nurses the child, to know if she 
really or only apparently, treats the infant with tenderness. 
She should also try to assure herself if the nurse is willing, 
peaceable, or quarrelsome and malicious. She should note 
further, whether the child remains healthful, lovely and 
blooming. If the contrary appears since the time that the 
mirse has suckled, we may suppose that the milk of the 
woman does not agree with the child, or is not sufficiently 
nutritive. In this case it happens frequently that the child- 
ren are already uneasy, during the first weeks of receiving 
the milk, are troubled with diarrhoea, flatulency, spasms 
and eruptions and fall away. Under these circumstances it 
becomes absolutely necessary to change the nurse. 

If on the contrary the mother has reason to be satisfied 



70 THE NURSERY ROOM. 

with the nurse, she should also observe towards her those 
duties, which she owes to a person, who is to the child, 
what she is either unable or unwilling to be. She should 
not treat the nurse as one of the lower servants, for although 
it cannot be denied, that the majority of them, choose this 
life, for the sake of money or for the love of good living, 
yet we may be certain that many of them feel it bitterly 
that they give to a strange child, that, of which they deprive 
their own. 

There are also many cases, where women are forced by 
their parents or their husbands to go as nurses ; these will 
doubly feel a kind and considerate treatment, and certainly 
repay it by affection and devotion towards the child, which 
has been entrusted to their care. 

As to the food of the nurse, it should be simple and nutri- 
tive, for, spicy, fat and luscious victuals, the taking of spirit- 
uous liquors, create acrimony in the fluids, and make circu- 
lations sluggish. Wherefore, she should be very temperate, 
even in the use of small beer, the only beverage she ought 
to drink, besides water. 



THE NURSERY ROOM. 

It should be in a quiet part of the house, near the sitting 
room, have plenty light with a southern aspect. It ought 
to be dry, the air pure and free of all vapors ; washing and 
drying of clothes should be strictly prohibited, nor should it 
be heated from within, particularly by stone-coal, and all 
fumigating with odoriferous things should be avoided ; flow- 
ers, birds and other animals should be banished entirely. 

The child, accustomed in the womb of the mother, to the 
rocking motion, the quiet repose and the luke-warm tern- 



THE NURSERY ROOM. 71 

perature of the waters, which surrounded it, knows neither 
the air, the cold, the sound nor the light ; wherefore, in the 
first days of its existence, it is peculiarly sensitive, and we 
should look to it, that it be not exposed too abruptly to any 
of these influences. The temperature of the room should 
never exceed 18° Reaumur (72|° Fahrenheit), and later 
not 16° R., (68° F.) 

During the first week the room should be kept dark, and 
the rays of the sun, of the moon, and every other light be 
excluded. All noise should be kept away from the nursery, 
it hurts the baby when awake, it disturbs it in its sleep. 

The best way of keeping the air pure, is to exclude all 
exhalation and all vapors, and to allow no one but the 
nurse or the parents to sleep in the room ; but as, notwith- 
standing these precautions, the air, by the constant con- 
sumption of oxygen, becomes charged with too much nitro- 
gen, and at last may be injurious to the babe, it is necessary 
to purify it, once or twice a day, by changing it for the fresh 
air out-side. Let, therefore, the child be brought into an- 
other room, and open the windows of the nursery for an 
hour or two. Then let the child be brought back, after the 
windows have been shut and the temperature of the air 
has been restored to the usual degree. When the external 
atmosphere is not below 12° R. or 59° F., if the weather 
is neither rainy nor windy, and there is. no draught in the 
room, we may open the windows, even in the presence of 
the child. For pure air does not only contribute to the 
preservation of the health and growth of the child, but is 
absolutely necessary, if we wish it to thrive. 

When the air, we breath, does not contain a sufficient 
portion of oxygen, the blood is deprived of that material 
w T hich preserves it from stagnation and corruption. But not 
only through the disproportion of the oxygen gas to that of 



72 THE NURSERY ROOM. 

hydrogen gas, does the air become injurious, but also through 
all kinds of exhalations, such as vapors, combustibles, the 
evaporation from men, animals, plants, through all putrified 
matter which makes the air more or less unfit for breathing. 

As, however, the air in rooms, notwithstanding our ven- 
tilating them several times a day, is not always quite pure, 
when these rooms are situated in the narrow streets of large 
cities, in low places, near brooks and rivers, it cannot be 
sufficiently recommended to the mother, after the first six 
weeks, when the air is not too cold, when it is neither rainy 
nor windy, to carry the child, at least twice a day, into a 
meadow or garden, and leave it there an hour or two, if the 
season is fine. 

When the child is six months old, we may, at any sea- 
son and during any weather and temperature, carry it or 
drive it out without the least apprehension. I do not mean 
that it is to be put in a close coach, with the nurse, the 
child's maid and three or four other children, which soon 
make the pent up air still worse than that in the room. A 
drive should only be taken in an open carriage. 

The best light for the nursery is that of a spirit lamp or 
wax light, as they cause the least vapor. The flame of 
tallow candles and oil lamps does not consume their fat and 
other constituent parts, but communicates them in the form 
of smoke and vapor to the air of the room, and thence to the 
lungs, particularly to those of a delicate child, to which 
they become highly injurious. Equally detrimental are 
charcoal pans, warming-pans, or what is called fumigating. 

As it has already been mentioned before, no clothes should 
be washed, dried or ironed in the nursery, because this, as 
well as scrubbing the floor, through the evaporation of the 
water, produces a bad effect upon the respiratory organs of 
the child ; the latter should only be done in absence of the 



THE BATH. 73 

child, which should not be brought back until the floor has 
become perfectly dry by open windows. 

Particular attention also should be paid, that no dirty 
water, slops, or chambers are left in the room, 



THE BATH. 

If fresh, pure and wholesome air is indispensible for the 
preservation of the child's health, the cleanliness of its skin 
is not less so, for, whatever ignorance, prejudice, or the 
idleness of midwives, nurses, and child's maids, may say 
to the contrary, it is the preventive of a host of diseases. 

The situation in which the child was for nine months, be- 
fore it was born, surrounded by water, and in a manner 
living in this element, shows us that it requires the bath. 
To remove the cheesy mucus, which covers the child, when 
it is born, an immediate bath is necessary, and thus nature 
teaches us that the bath is one of the first requisites of the 
infant. The bath also quiets the child : most children 
when put crying into the water, become silent, and some- 
times go to sleep in it. 

Therefore, as soon as the navel-string is separated from 
the mother, let the infant be put into a bath, which should 
not be under 20° Reaumur (77° Fahrenheit), nor above 
24° Reaumur (86° Fahrenheit). 

The bath-tub should be large enough, to cover the child 
entirely, with exception of the head. I have frequently 
seen children bathed, when only part of the body was 
covered with water, whilst the nurse tried to wet the other 
parts by laving it with the hands. This is improper, it is 
the first cause of the child catching cold, and the partial 

7 



74 THE BATH. 

immersion produces a disagreeable sensation, which ge- 
nerally makes the child cry, the reverse of the effects of an 
entire immersion. 

When the bath has been prepared, in the manner de- 
scribed, the midwife or nurse takes the child on the flat of 
her hands, and supporting the head with her left hand so 
as to raise it, she lowers it gradually and slowly into the 
water. When this has been done, she should first clean 
with a fine rag the eyes, the nostrils and the mouth, of the 
mucus which fills them, and examine whether there are not 
some malformations, or, if the child is tongue-tied, etc. As 
soon as these parts, as well as the face have been cleaned, 
she should wash the rest of the body with a fine sponge. 
Should the coating not yield to the washing with water, 
the infant may be rubbed with some unsalted butter, or 
with the yoke of an egg. After this, it may again be put 
into the water ; the bath, however, must not last more than 
twenty minutes, and not get cool, but the same temperature 
be sustained, by adding warm or cold water. 

When the child is bathed, it must be well dried, wrapped 
in swaddling cloths, which have been warmed in the bed 
of the mother, and thus rolled up, every time after the first 
two or four baths, brought into bed with the mother. The 
baths are to be continued in the fore and in the afternoon, 
under the same circumstances. 

We should be careful, as I have observed before, not to 
touch the eyes of the child with the sponge, with which the 
infant was washed in the beginning, it is difficult to remove 
the cheesy matter (vernex casceosa) from it, which being 
brought in contact with the eyes, might cause very malig- 
nant inflammation in these organs. 

Care should also be taken not to bathe the child until an 



THE BATH. 75 

hour after it has been suckled, and not to put it again to 
the breast, until at least half an hour has expired after the 
bath. 

A long experience has convinced me of the great advan- 
tages of gradually hardening the constitution of a child ; 
to obtain this object, one of the principal means is bathing 
in cold water. I have witnessed thousands of examples, 
where, by the washing and bathing, not only a numerous 
train of diseases of children were prevented, but where, 
when those diseases appeared as an epidemic, they passed 
off quickly, and without any malignant symptoms, and, 
therefore, I feel myself called upon, although many physi- 
cians still declaim against their use, to recommend them, 
most strenuously. They should be applied according to 
the undermentioned plan. 

As a practical physician, I have had many opportunities 
of witnessing, that cold washing and bathing of children, 
not only fortifies their constitution, protects them from 
sickness, and causes these diseases by which they are 
attacked to pass off easily and mildly ; but that even, 
where children to their sixth or eighth year were crippled 
and sickly, in consequence of Rachitis (rickets), scrofula, 
etc., and in order to prolong their miserable existence were 
obliged to take medicine constantly, without improving, 
they were restored to health, by the sole use of cold wash- 
ing, bathing, affusion, combined with proper diet, clothing, 
exercise, and the enjoyment of pure, fresh air, and became 
blooming and strong. 

After the child has been bathed in water of the aforesaid 
temperature for six weeks, we should fall 2° Reaumur (4|° 
Fahrenheit), and continue so, for the next month, so that 
when the child is ten weeks old, the temperature has been 
reduced from 24° to 20° Reaumur (from 86° to 77° 



76 THE BATH. 

Fahrenheit), afterwards, the temperature may be reduced 
one degree, (2J° Fahrenheit), until in the sixteenth week 
the temperature stands at 15° Reaumur (65|° Fahren- 
heit), observing, that as we reduce the temperature from 
24° to 15° Reaumur (86° to 65|° Fahrenheit), the dura- 
tion of the bath must be gradually diminished from twenty 
minutes to five minutes. When we have succeeded in ac- 
customing the child to bathe daily twice, from three to five 
minutes, in water of 15° Reaumur (65 f° Fahrenheit), 
slight friction being applied at the same time, we may con- 
tinue in this manner, without making any change, until the 
child has cut its first tooth, and has been vaccinated. 

An exception must be made with children, who are very 
weakly and sensitive ; they may be bathed in the above 
temperature until they are three years of age. 

After the child has got the first tooth, and has been vac- 
cinated, we may lower the temperature to that of spring, 
hydrant, brook, or river water, and wash the child from 
two to five minutes, rubbing it all the time. With children 
who are otherwise strong, but who have a disposition for 
scrofula or rachitis, affusions by means of a small watering 
pot may be applied, besides the bath ; in the warm weather 
this should be done twice a day, in winter daily, after 
rising. 

After the fourth year, the washing should be continued 
uninterruptedly, and a bathing sponge be used ; in time the 
child will become accustomed to the water, it will feel the 
want of it, continue so when it grows up, and enjoy good 
health. Besides this washing, we must look to it, that the 
children accustom themselves early to bathe in the rivers, 
and that they learn to swim. Experience teaches us that 
by this washing, not only cleanliness of the body is effected, 
that the skin is kept in constant activity, and becomes for- 



THE BATH. 77 

tified against external influences, such as cold and wet, but 
also that the whole organisation gains by it, in accelerated 
growth, in strength and in a peculiar power of reaction, 
which leaves it less sensitive, and enables it to overcome 
more easily all epidemic and endemic diseases than any effe- 
minate system could do. Numerous instances have shown 
us in later years, how few children, which are accustomed to 
wash and bathe daily, are attacked by quinsy, scarlet fever, 
purples, measles, small pox, and other prevailing diseases ; 
and if we find single instances, where this is the case, how 
soon they recover from these diseases, whilst those chil- 
dren, who are not accustomed to cold washing, are deci- 
mated at the appearance of every epidemic, one half of 
those who escape, looking for years after, like corpses and 
suffering from the consequences. 

Useful as cold washing is in these diseases, which are so 
much dreaded by the parent, and with right, it is equally 
so during the time of teething, for I and other observing 
physicians have found invariably, that children, who are 
accustomed to the cold bath, pass the period of teething, not 
only with ease, but that the majority do not show symptoms 
of sickness. 

Certainly nobody can, nobody will deny the great advan- 
tages of learning to swim early ; it contributes to the clean- 
liness of the body, and through the cold, the magnetic in- 
fluence of the river water, and the varied mechanical exer- 
cise of the body, is of infinite benefit to the child. 

Therefore, parents, guardians, friends and principals of 
public institutions should renounce all prejudice, and should 
convince themselves, how extremely advantagous it is, to 
accustom children to wash and bathe in cold water, and to 
learn to swim when young. Do not believe the adversaries, 
who, notwithstanding their want of all theoretical know- 

7* 



78 THE BATH. 

ledge and practical experience of their sufferings, write so 
much against it, merely to prove to the world, that their 
manner of treatment is infallible, and that all the rest is 
nonsense. Go, convince yourselves in Hydropathic insti- 
tutes, in private houses, where washing and bathing of 
young and old has become a rule ; make experiments on 
yourselves and your families, and you will find that I have 
not praised it too highly, you will communicate to others 
your own experience, and thank God that you have be- 
come acquainted with it, for from that time forward your 
house is rid of doctor and apothecary, and with them of 
everlasting sickness, and you have effected a considerable 
saving in your expenditure. * 



^Ferdinand Jung, a citizen in middling good circumstances, in Stock- 
rau, father of eight children, was, according to his own account, always 
sickly, also his wife and his children, so that the house was never rid 
of the physician, and 100 fl Conv. coin, ($50) a year, scarcely sufficed 
to pay the medicines. 

In the year 1839, I was engaged as domestic physician by F. J., and 
although I had many prejudices to overcome, I succeeded, notwithstand. 
ing, in the course of a year, after having effected the cure of really dif. 
ficult cases, and attained the most brilliant results, to induce the family 
to adopt as only remedy, cold water. By this means, this family, 
who had been always sickly, does not only enjoy the pecuniary benefit 
of saving the money, which they were in the habit of paying to the 
doctor and apothecary, but all the members of the family have for five 
years enjoyed good health, with exception of a couple of cases of erup- 
tion or ra«*h, and a lymphatic abcess of great size on the exterior tro- 
chanter of the left upper-thigh, which, as well as the eruptions of the 
skin yielded, without any difficulty, to this natural treatment. 

Most conspicuous did the healing power of the water show itself in 
its effects upon the wife ; hitherto she had been weakly, had suffered 
from nervous attacks, from hemorrhage at every birth, in consequence of 
adhesion of the placenta ; since she commenced to use the water, she 
has given birth without any accident or delay, and has suckled her 
child, which was bathed every day, already more than a year. 



FOOD. 

To preserve life and to develope the physical capacities 
of any living being, a proper food is undoubtedly the most 
indispensable requisite. This being generally admitted we 
shall now take into particular consideration the food, which 
is most suitable for the infant. 

The organization of the child being imperfect, the neces- 
sary secretion of saliva, the power of mastication and the 
muscular strength of the stomach, are too weak, as that the 
contractive power and the dissolving juices of the latter 
organ, should digest the substances which we might offer to 
it. It is principally the thin intestines, which, by the many 
absorbent vessels, they contain during this period of life, 
contribute to nourish the infant, and thus make up for the 
imperfect secretion of saliva, and the want of contractive 
force in the stomach. 

In speaking of the food of a child, we can consequently, 
only have re Vence to liquids. The child, which immedi- 
ately after be lg born, is nothing but a perfectly developed 
foetus, which in the womb received its nourishment through 
the vessels of the navel-string and of the skin, requires to 
be nourished by the juices of the mother, not in the same 
manner as before, but through the breasts, because the milk 
resembles most those juices, which have fed it hitherto. 
This, no reflecting human being, who endeavors to trace the 
course of nature, will deny. 

The importance of the mother suckling her child herself, 
has already been discussed, but as there are cases, where 
this is not practicable, our first business will be to examine 
what food is most suitable to take the place of the mother's 
milk. 79 



80 FOOD. 

The first of all, is undoubtedly, the milk of the nurse, 
because it approaches that of the mother nearer than any 
other liquid. But as we cannot always obtain this accord- 
ing to our wishes, w T e are obliged to have recourse to other 
articles, and feed the child with a spoon. By some physi- 
cians this has been entirely rejected, as very injurious, and 
they attribute the great mortality in foundling hospitals to 
this system, yet numerous cases prove that children, in 
cases where it was really necessary, and w T here proper care 
was combined with this system of feeding, have grown up, 
strong and healthy. Where casualties occur, it is generally 
owing to a bad constitution of the child, sickness, or im- 
proper food. 

If the feeding of the child has become unavoidably neces- 
sary, let the mother or nurse observe the following rules 
carefully and conscientiously : 

In the first instance, the preparation of the well chosen 
articles of food, should be suitable to the tender age and 
w r eak digestion of the child. It should always be prepared 
a fresh. 

The feeding of the child should be performed with great 
care, patience and perseverance, only small quantities should 
be given at a time, and frequent intervals be observed in the 
feeding, a thing very troublesome, and connected with 
great inconvenience, yet the mother will be sufficiently re- 
warded in the feeling of having reared by her industry and 
perseverance, a helpless, weakly infant, to be a strong and 
healthy child. 

But the exact observation of these two rules is insuffi- 
cient, when the greatest cleanliness is not connected with 
it ; useful as it is in the nursing of every new-born babe, it 
is doubly so in this case. 

Through the uncleanliness of the vessels, in which the 



FOOD. 81 

food is prepared, and given to the children, it becomes sour 
and spoils, and if given to the child, produces derangement 
in the digestive functions, frequent eructations, sourness of 
the stomach, vomiting, flatulency, thrush, and diarrhoea, 
and may even endanger its life. The mother should, there- 
fore, look to it, that the vessels are kept constantly clean, 
and that the food is prepared a fresh every time. 

Above all, the so-called sucking bags should be avoided, 
they are dangerous ; the food in them turns sour very soon, 
against which even the greatest cleanliness is no safeguard. 

The mother should never allow the nurse to take the 
food of the child in her mouth and to roll it about, to mix 
it with her saliva, and perhaps to extract the most nutritive 
parts. Independent of the disgust, which this conduct must 
excite, particularly when the nurse is a toothless old wo- 
man, it is always injurious to the child to have its food 
mixed with the saliva of another individual, which but too 
often is secreted from impure juices. 

As to the kind of nourishment, it has been proved, that, 
for the first fortnight, liquid food is most appropriate, par- 
ticularly a mixture of two-thirds of pure, warm goat's, 
ass's, or cow's milk, if possible, fresh from the animal, 
and one-third of fresh water. Care should be taken that 
the animal, from which the milk is obtained, is sound, and, 
if possible, that it has not had young ones more than four 
times. The milk of an animal, which is still sucked by its 
young, should not be used. It should be boiled every time, 
it is wanted, be mixed with the said quantity of water, and 
be of the temperature of the mother's milk. Not too much 
must be given to the child at once, but at intervals, and as 
often as it manifests a desire for it, by seeking, playing with 
the tongue, sucking with the lips, or by crying. 

When the child is healthy and growing, we may change 



82 FOOD. 

the articles of food. The best by far, is a pap of well 
baked buiscuit or wheaten bread, boiled in water. This pap 
is to be prepared in the following manner : — Take pounded 
or grated biscuit or wheaten bread, boil it in half a pint of 
warm water, stir it often, until the crumbs are dissolved 
entirely ; then add a piece of sugar, mix it well, and give 
the child, according to circumstances, from eight to twelve 
tea-spoonfuls, four or six times during the twenty-four 
hours ; during the intervals, give the above mentioned 
drink of milk and water. Care must be taken that the 
pap is neither burned or smoked, and is always prepared a 
fresh. 

By degrees, we may pass on to stronger articles of food ; 
the time must, of course, depend upon the strength of the 
child, because sickly and weakly children require a more 
nutritious food than others. From the fourth to the eighth 
month this should consist of the same pap, described above, 
with this alteration that instead of boiling the biscuit or 
wheaten bread, in water, we may now use for this purpose, 
unsalted broth, made of veal, chickens, or pigeons ; other- 
wise the preparation is the same. 

To feed the child, we should use small wooden or silver 
teaspoons, which ought to be rather flat, not too deep. A 
second spoonful should not be given until, the first has been 
entirely swallowed. To give the child to drink, we should 
have one of these suckling glasses or baby-glasses, which 
may be had in every glass store. 

At the end of seven or eight months we may give more 
solid food, the same as to the children, who have been 
weaned, but for drink, nothing but fresh water. 

The articles of food which the child is to receive now, 
and which ought to be given at regular periods should con- 
sist, in the morning, of a soup, made of wheaten bread, to 



FOOD. 83 

which, when the child is weakly, may be added a small 
piece of butter and some of the yoke of an egg ; or of pure 
boiled cow's milk, of coffee made of burnt acorns, barley or 
wheat, with soaked wheaten bread, which meal may be re- 
peated at nine or ten o'clock. 

At noon, a good, clear beef-soup, with bread boiled in 
it ; things prepared from flour, rice or groats, or milk-por- 
ridge ; and a piece of white bread at three or four o'clock 
in the afternoon. In the evening, the same should be given 
as at breakfast. 

As soon as the child begins to walk, a small piece of soft, 
tender meat, of any kind, not too much boiled, roasted or 
fried, should be added to its dinner. It should accustom 
itself to take for its breakfast pure milk with black rye 
bread, and its dinner should consist as already said of some 
meat, or a simple and nutritive preparation of flour and a 
piece of bread. 

On account of the rapid growth, and the very high 
power of reproduction, during the first years of life, the 
digestion of the food is much more rapid, and the chyle 
absorbed much sooner than in the grown subject ; as a com- 
pensation, the child requires to eat much oftener than the 
man. We should, therefore, give the child food at fixed 
hours, without over feeding it ; besides dinner, breakfast 
and supper, it should have, about nine or ten in the morn- 
ing, and about three or four in the afternoon, some white 
bread and milk, butter or fruit. 

How much a sufficiency of simple, natural food, of good 
quality, like this, contributes to the physical and mental 
development of the child, has been proved by thousands of 
examples, and it would be well, if this system of feeding 
were adopted generally. 

Care should be taken, that the stomach be not over- 



84 FOOD. 

loaded, because this makes children weak and sickly ; 
regular simple food, on the contrary, makes them strong 
and healthy. 

Irregularity in meals, want of moderation, the frequent 
use of sweets, have certainly a baneful influence upon the 
health of the child, and interfere with its physical and mental 
cultivation ; but just as injurious, if not more so, is the use 
of spiced or spiritous drinks, which, from misconceived 
love, or unfounded fear for its health, are given to the child. 
But, worse than -all, is that mania, which still prevails in 
many families, and which arises from superstition or ignor- 
ance, that every time the child cries, it must have a dose 
of medicine : unfortunately, there are, among the host of 
physicians, some, who, instead of opposing this foolish and 
injurious idea, are themselves unreasonable, or from inter- 
ested motives, base enough, to encourage and sustain it. 

What I state here is true ; many years of experience as 
practical physician and accoucheur have furnished me with 
the proofs. There are, to this day, families enough, where 
every thing is done, to make a hospital of the nursery. 
Scarcely has the poor child seen the light of this world, and 
saluted it with a cry, when aunt, grandmother, physician, 
midwife, all want to know better than nature. Every time 
the child cries, a new advice is given ; the one says cold, 
the other warm, the third comes with camomile, manna or 
rhubarb. The one finds the child too thin and too weak, 
he wants to alter, and effect by his wisdom, what nature 
has failed to do in the womb of the mother : he bathes the 
child with wine and herbs, gives it very nutritive articles of 
food and strong drinks. The second says : the belly of the 
child is too large, make poultices of herbs, give it injections, 
a purgative. Now the poor infant cries night and day, the 
assistants pity the mother, that she cannot sleep, and the 



FOOD. 85 

paid nurse pities herself most. What is to be clone ? A 
decoction must be prescribed, which is to quiet the child, to 
make it go to sleep, that the grown persons can enjoy their 
rest ; certainly it is quiet, it sleeps, that it may have the 
better cause to cry when it awakes. Then comes teeth- 
ing, some irruptions, perhaps the quinsy, if it is fortunate 
enough to live so long, and— the child dies. 

Now every body blames the disease ; but I say, the drugs 
did it ; they undermined the health of the child to such a 
degree, that nature had not strength enough, to resist the 
disease properly. 

According to the principles of nature and science, every 
thing we take, that contains no nutriment, but produces only 
temporary, exciting, weakening or other effects on the 
human organisation, is a medicine. As, therefore, it is not 
a dietetic substance, which the animal functions can appro- 
priate, it requires a peculiar activity in the human body 
to meet the greater or less effect ; for there is no specific 
remedy, which acts upon the disease, without at the same 
time effecting the whole state of the body. 

When the child is sick, the nature of its organisation 
exerts itself to the utmost, to expel the morbid matter : the 
whole strength makes one effort to overcome the power of 
the disease, as is seen in the heightened temperature of the 
skin, the increased circulation of the blood, chills, heat and 
other symptoms. In consequence of these interruptions of 
its organic functions, the child cannot bear the usual food, 
as it wants the power of digesting it, and yet we require its 
vital power to overcome substances as foreign, nay, as op- 
posed to the human system, as medicine is. This latter does 
not only operate against the sickness, but once taken, acts 
either dynamically and generally, or mechanically and lo- 
cally. By this means the disordered functions are obliged, 

8 



86 



FOOD. 



according to the quantity and effect of the medicine, to 
divide their power and to struggle, not only against the 
power of the disease, but also against the unwonted effects 
of the medicine. 

At every repetition of such injurious influence, the body 
is obliged to repeat the process just related, whilst its 
natural powers become weakened, to such a degree, that 
they can no longer resist the force of the disease, but con- 
sume themselves and sink rapidly. In consequence of the 
remedies given, particularly of powerful medicines, new 
phenomena appear, which but too often are looked upon by 
the physician as an aggravation of the disease. He now 
considers himself in duty bound, to prescribe other mixtures, 
sometimes changing the medicines, more than once a day, 
to overcome the same disease. And yet this disease has 
neither changed its form nor its character, only the pheno- 
mena of the re-acting power, have manifested themselves 
differently, according to the intensity of the medicine, 
which has been taken. 

The internal organic power, with which nature has en- 
dowed man, tries to expel from the body all that is injurious. 
For instance : by vomiting, when the stomach has been over- 
loaded ; by inflammation, festering, diarrhoea, fever, &c, 
when metals, splinters, poisons, infectious matter, have en- 
tered the body. If now, the organic power is divided, and 
obliged to act, on one side, against inflammation and 
inhaled miasma, on the other side, against the swallowed 
strong medicines, nay, if besides, it is weakened by constant 
blood-letting, it is but too often the case, that the re-action 
is insufficient, and by too frequent efforts consumes its own 
power. The disease then becomes so powerful, that the 
functions finally succumb. If, on the contrary, the natural 
healing powers of the human body are stronger than the 



CLOTHING. 87 

cause of the disease, and that the medicaments used against 
the latter, do not interfere with the operation of the former, 
they will come forth from the struggle victoriously, and the 
disease must give way. 

We should, therefore, by no means, be too quick with 
the use of medicine, particularly not with children, and 
never give them, without consulting an experienced, consci- 
entious physician. We should be cautious how we em- 
ploy, at the mere advice of old women, midwives, nurses and 
gossips, who are always ready with their counsel, tea, pur- 
gatives, injections, spicy, odoriferous fumigations, fomenta- 
tions of aromatic herbs, of wine, or the like. We should 
consider that the weak, nervous system of the child is over- 
excited by such stimulants, and that, sooner or later, nerv- 
ous attacks, convulsions, debility, disturbed sleep, cholic, 
indigestion, &c, are the consequences ; whilst, with neces- 
sary rest and proper diet, the nature of the child alone 
would have sufficed to overcome the disease. 



CLOTHTNG. 

The first object of clothing the infant, is to protect the 
navel-string from every violent tension, to sustain the per- 
spiration, to counteract the external influences, and to main- 
tain cleanliness. It should be done in the following man- 
ner, which is according to the dictates of nature : 

After the child has been bathed as described, it should 
be wrapped in one Oi more cloths, and then be placed 
alongside of the mother, to have its first sleep, if the con- 
dition of the mother allows it. As soon as it awakes from 
its slumbers, it should be taken to a quiet place, which is 
properly heated, where the air is pure and the light soft, 



88 



CLOTHING. 



and where the necessary articles of clothing have been put 
in order before-hand. 

The first proper and natural clothing consists of a cap, 
in the form of a net, a strongly-knit bodice, a shirt with 
long sleeves, descending to the heels, which should be tied 
behind ; a small linen handkerchief, which is put on the 
child over the shirt, in such a manner as to cover breast and 
neck ; and of a linen napkin, which encloses the abdomen 
and thighs, the two ends of which are placed under the 
perinseum ; a four-double fine linen pad, and an elastic 
bandage of this form 




The parts from a to b consisting of some elastic substance, 
best of India rubber ; the centre piece c of a five inch wide 
ribbon, and the two ends d of diapered, three inch w T ide 
ribbon, which, at about four inches from both ends, should 
be provided with three tapes a quarter of an inch wide. 

When all this is ready, the child is placed upon a table, 
upon which there is a pillow. After the nurse has con- 
vinced herself, two or three hours after the birth of the 
child, that the navel-string, which for the moment was 
wrapped in cloths, is no longer bleeding, the same should be 
tied once more, the end be covered with fine burnt rye flour, 
be enveloped in a small fine rag, pressed close to the abdo- 
men, and be covered with the above named square pad of 
linen; after which, the belly-band is put on so that the 
middle of the wide part c fits upon the navel-string, and the 
two pieces, a ft, upon the sides of the abdomen, in such a 



CLOTHING. 89 

manner that the two end parts, which towards the loins 
become narrower, cross at the back, without making plaits 
or pressing the child, when the two terminating parts d, the 
one on the right, should be brought round to the left, and 
the one on the left to the right, towards the centre of the 
abdomen, so as to cover each other exactly at the navel, 
where, after having been tightened, they are fastened by the 
three pairs of tapes, tied in bows, exactly over the linen 
pad. 

This kind of belly-band or navel-band possesses the fol- 
lowing advantages over all other kinds, it is easily put on, 
preserves cleanliness, and keeps the pad in its place ; in 
consequence of its elasticity, it does not interfere with the 
respiration of the child, nor with the play of the abdominal 
muscles ; it also compresses the abdomen uniformly. 

When the belly-band has been fastened, we place the 
child upon the napkin, which has been doubled corner 
ways, in such a manner, that the centre is under the seat, 
and the doubled edge under the loins, we draw the two 
unfolded points, which lie over one another, through the 
legs, and turn them up over the lower part of the belly ; 
w T e then turn the two ends of the napkin, which project on 
each side, over the thighs inwardly. This napkin serves to 
keep the child clean. Next we put on the three cornered 
handkerchief, which must be held in readiness, bringing it 
from behind over the chest and back again, over this we 
draw the shirt and then the bodice, which must reach below 
the navel, observing that the sleeves of the shirt must be 
turned over those of the bodice. Both the shirt and bodice 
are to be tied behind, but in such a manner, that the knots 
or ties do not hurt the child ; after this, we put on the cap, 
which we fasten with a broad ribbon, and then place the 
infant in bed. The bed is kept together, either by one 



90 CLOTHING. 

broad band or by three ribbons, that the child in a manner 
is enveloped in it, yet not too tight, so as to leave its mo- 
tions unimpeded. The hands, from the very beginning, 
should be left free, and not be wrapped in flannel, canton- 
flannel, woolen or cotton; it only effeminates the child, 
makes it too sensitive to all external impressions and 
leaves its skin too delicate. 

Unfortunately we find still among the higher classes, 
where extravagance, splendor, and the love of fashion pre- 
vails, either from ambition, from prejudice and custom of 
the grandmothers and aunts, or from the folly of the mid- 
wife, who puts on the garb of wisdom, the habit of lacing 
the children tightly, during the first few months of their 
life, although in the narrow space of the womb they were 
unconfined. We still see frequently a mode of dressing 
the child, which is diametrically opposed to that described 
above, and the most uninitiated observer will perceive the 
evident torture of the infant, by its vain endeavors to free 
itself from its bonds, by its anxious and pitiful face ; he 
will hear it, in its appealing mournful cry. In spite of all 
this, and notwithstanding the anxious and pitying looks of 
the mother, the infant which has scarcely come into the 
world, is placed upon the rack. Under pretext of preserv- 
ing it from ruptures at the navel and at the groin, (hernia 
umbilicalis and hernia inguinalis), a two fingers wide 
bandage, the edges of which cut deep into the tender soft 
fat of the child, and rolled from ten to twelve times, and 
sometimes oftener, firmly round the belly, in such a manner 
that it is difficult to introduce a finger between the bandage 
and the skin. How, in this situation, are the weak muscles 
of the child to expand ? But this is not enough — the cir- 
culation of the blood is only interrupted in one place, that 
it might be general, they wind and fasten a second, some- 



CLOTHING. 91 

what wider bandage, over the shirt, handkerchief, perhaps 
another canton flannel wrapper, a large piece of flannel, and 
a mass of cloths rolled round the legs, which are stretched 
out by force, and that the head and neck may not be spared, 
the former is frequently covered with a cap, which is richly 
ornamented with beads, lace and ribbons, which do not 
allow the poor little sufferer to lay down his head when at 
rest, without hurting it. Now the chin-band, (chin-stays), 
through which the dribbling cloth is passed, is fastened 
under the jaw, the dribbling cloth drawn down, and fas- 
tened to the body. By this means every motion of the 
head, either sideways or backwards, is made impossible. 
Yet all this does not satisfy them, when the child has been 
thus far metamorphosed, they forcibly stretch out the arms 
as they have already done the legs, which before birth have 
been in a curved position, and press them firmly to the 
body by means of a bolster or wrapper ; over all this, they 
put, w T hat is called the swaddling bandage. 

Thus laced together, the poor creature, whom a wise 
providence allowed free motion in the womb of the mother, 
by means of the waters, unable to move a limb or to draw 
breath with freedom, swaddled up to the mouth, eyes and 
nose, like an Egyptian mummy, and as stiff as a stick of 
wood, is handed over to the mother, who cannot give way 
to her delight, because she is frightened by its uneasiness, 
by the increased redness of the face, and by its plaintive 
cry. 

Should not every tender, loving, and reflecting mother 
be frightened, and tremble, when she sees the horrid 
squeezing of her child, when she perceives its anguish and 
uneasiness, when she considers its former existence, and 
compares it with its present state, produced by this lacing. 

The mother and every other reflecting individual must 



92 CLOTHING. 

see, and every physician will confirm it, that by the pres- 
sure of the bandages and swaddling clothes, breathing, 
which has scarcely commenced, is checked, preventing the 
proper circulation of the blood, which strives to return to 
the former channel, pressing towards the parts around the 
navel, and frequently causing bleeding out of the navel- 
string. There are instances on record, that these were not 
observed until the pale face of the child betrayed the secret, 
when, before the careful packing up of the infant could be 
undone, the loss of blood had exhausted the baby, or, per- 
haps, killed it. Although we must confess that these ex- 
treme cases are rare, yet the consequences which this tight 
swaddling, this mummifying has, sooner or later, upon the 
health and life of the child, are too important, as that they 
should not merit the full attention of every mother and of 
every father of a family. 

By its entrance into this world, where he is a stranger, 
the little delicate creature, which does not terminate its 
growth until much later, begins a new life : by the first 
respiration and the new mode of obtaining food, a new 
epoch begins in the process of sustaining life ; wherefore, the 
infant must be exceedingly sensitive to all external impres- 
sions. The eye, the ear, in fact all organs of sense, but in 
particular, the skin of the infant, is very irritable, for in its 
former world, in the womb of the mother, the child came 
in contact with nothing but the waters and the delicate 
membranes of the womb, and was, moreover, covered with 
the cheesy coating. 

Now the child comes into the world, and with the first 
breathing of the air, commences the function of the skin. 
But how is this to proceed, when the heavy load of cloth- 
ing prevents all motion, and their tightness excludes every 
approach of atmospheric air, every wholesome perspiration, 



CLOTHING. 93 

and does not allow the small capillary vessels to expand, 
thereby limiting the circulation of the blood in these latter ; 
the consequences of which is, that the child is made un- 
comfortable, and the foundation of a host of diseases is laid. 

Besides the suppressed functions of the skin, and the 
interrupted circulation of the blood, the child now is at- 
tacked by a feeling of giddiness, and tortured by an itching, 
caused by the closely adhering seams, bandages, strings, 
&c. ; this produces a very troublesome feeling, which, as 
the tight bandage prevents the child from breathing is 
heightened to actual anguish. But the poor creature can- 
not speak ; its terrified pitiful faces no one will understand, 
and at last, it has, by instinct, recourse to screaming. This, 
too, is misunderstood, and the poor infant is sometimes even 
blamed for it by its unreasonable tormentors. So it hap- 
pens, not unfrequently, that whilst the tight swaddling is 
continued, not only the germ of after disease is planted, but 
apoplexy is brought on, terminating the life of the child, 
which has scarcely commenced. 

If mothers would only look at the animals, how they try 
to preserve their young from every pressure, they would be 
obliged to confess, that exactly through the free motions 
of the young animals, they are protected against being crip- 
pled, hump-backed, lame, &c, and they would see, also, 
that they are not liable to ruptures at the navel, in the 
groin, or thigh, a misfortune to which our delicate children 
are very subject. For this we should blame nothing but 
circular, or navel-bands (belly-bands), which old custom 
and deeply rooted prejudice keep in general use, as they, 
instead of preventing ruptures at the navel, have, in conse- 
quence of their unusual pressure, exactly the contrary effect ; 
a thing which is very natural, for, if the bandage be tied 
too loose, it will, during the struggling and screaming of 



94 CLOTHING. 

the child, either glide from the middle of the belly upwards, 
towards the chest, the thinner part of the body, or down- 
wards, towards the pelvis. 

In the first instance, the chest is confined by the band- 
age, and the lungs are interrupted in their free expansion ; 
they try to gain space below, where the intestines are 
pressed downwards against the free and yielding abdo- 
minal ring, into and through which they penetrate, whereby 
ruptures and cases of prolapse occur in other parts. In the 
second instance, where the bandage slipped down to the 
pelvis, it compresses the lower part of the abdomen and 
thighs, thereby forcing the intestines upwards, towards 
the centre of the anterior part of the abdomen, that is 
towards the unprotected, not yet quite closed, umbilical 
ring, and causing umbilical ruptures, at the same time 
dragging and lacerating the navel-string very considera- 
bly, which may lead to inflammation, festering, and even 
to hemorrhages, which endanger life. 

The mother undresses herself, and causes herself and her 
grown children to be undressed, when they want to go to 
rest ; the greatest criminal may take off his garments, 
when he wishes to lie down, and stretch and bend his limbs 
as he pleases. No torture, of modern or ancient times, 
shows us an instance, where the criminal was obliged to 
remain for hours, weeks, nay months, night and day, with 
his arms stretched out and pressed to his body, and wrap- 
ped and laced in linen, or feathers from head to foot : but 
the delicate, fragile being, the new born infant must suffer 
this martyrdom, as long as it is thought necessary to con- 
tinue this over-lacing. It resists this violence, it struggles, 
it screams, but nobody will listen to its sufferings, nobody 
understand its terrified looks, its cold sweat, its redness, 
its oppressed breathing; it is always wrapped up again, 



CLOTHING. 95 

and the displeasure of the nurse increases, she draws the 
bandages so much tighter around the poor creature, and 
rejoices, when, after it is done, the child, exhausted by its 
struggles, stops crying or falls into a dose, from which its 
pains will awaken it but too soon, when again, its cry will 
commence. Now every body is ready to help, the mother 
in vain offers the breast, the nurse comes with tea, a third 
person offers eau de Cologne, but nobody thinks of freeing 
the poor infant from its wrappings, and when it is done, it 
is only to see whether the child is clean. As soon as the 
bandages are loosened, the child becomes quiet. But no- 
body attributes this silence to the natural cause, but as soon 
as it has been cleaned, or the nurse has convinced herself 
that it is clean, it is immediately packed up again in its 
tight covering, and should it scream again, rewarded by a 
couple of thumps upon the pillow. 

If those* who adhere to this old custom and prejudice 
with so much tenacity, would only suffer themselves to be 
laced and wrapped up for one day, in the same manner as 
the child is wrapped up, they would learn what torment, 
what sufferings they prepare for the poor little innocent ; 
they would understand its cry, and become convinced that 
the result of this compression must, sooner or later, prove 
injurious to the constitution of the child. 

There is not a single reason, which speaks in favor of 
this cruel enveloping of the children ; for to protect them 
from injury they have the mother, and the nurse, or child's 
maid ; and that they may not hurt themselves, nature has 
made the wise provision, that the infant as well as the ani- 
mal, is notified by pain to discontinue any motion which is 
injurious. Why are the nails of the infant not to be cut, 
with which alone it might hurt itself? In short, idleness 
and carelessness can be the only excuses for this method of 



96 CLOTHING. 

dressing the infant ; it enables the nurse to throw it, at any 
time, into a corner, and leave it there without paying any 
attention to it. No other animal leaves its young under 
these circumstances, only man, the noblest of all, and par- 
ticularly the feeling woman, puts her child to these tortures, 
notwithstanding her boasted maternal affection. 

We may continue to dress the child in the before-men- 
tioned loose clothing, until the third month, and during 
sleep, loosen even this, as much as possible. Only when 
the child begins to show, by voluntary attempts at rising, 
creeping and standing, the progress, which the muscular 
development has made, we should put on a free easy dress, 
suitable to its constitution. This ought to consist simply 
of the above described shirt, bodice and petticoat. As 
soon as there is a sufficient quantity of hair on the head, it 
may be left uncovered in a room of a moderate tempera- 
ture. When, during fine dry weather, the child is taken in 
the fresh air, a thing which is much to be recommended, 
it should wear, over the above-mentioned garments, an 
overcoat, which, in warm weather, should consist of cotton 
or linen, and in cold weather of woolen stuffs, and which 
must descend far below the feet, on which we should put 
shoes of cloth or sheep's wool. Besides this, a large shawl 
should be thrown over the head. When the child begins 
to walk, to which it should not be prematurely forced by 
go-carts, leading strings, and still less by leading by the 
hand, but simply by assisting it under the arms, it should 
have on, over the shirt, in summer, a gown of cotton, mus- 
lin or linen ; and, in winter, one of some woolen stuff, fast- 
ened loosely round the body by a belt. A handkerchief is 
tied over the breast, in such a manner as to leave the neck 
exposed, and when we take it out of doors, it should have 
on a hat of straw or of cloth, and its feet should be covered 






CLOTHING* 97 

with shoes. As soon as the child commences to creep about 
on the floor, a floor cloth should be spread out for it, as 
well in the house as on a grass plat. When the child begins 
to stand up and walk, the above-mentioned shoes should be 
worn. 

The same kind of dress should be continued until they 
are five years old ; as children, at this age, are more out 
of doors ; the girls, in particular, should wear, besides the 
shirts, pants, according to the season, of cambric or woolen 
stuff. When the weather is cold and damp, an overcoat 
of woolen, or of wadded silk, should be worn over the 
rest of the clothing. The shoes, instead of with felt, 
should be soled with leather. The wearing of stockings, 
by boys, until they are eight, and by girls, until they are 
five years old, is not only a useless and excessive precau- 
tion, but is even rather injurious, because, if they are not 
often enough changed, they will produce soreness of the 
skin, and erysipelas. 

By wearing the said light clothing, by breathing a pure 
fresh air, by free exercise, and by the recommended wash- 
ing and bathing, the skin of the child is strengthened, be- 
comes less sensitive to external impressions, and gradually 
accustoms itself to a cold temperature. The child is, there- 
fore, less exposed to disease, particularly to catarrhs and 
eruptions, and when attacked by them is more rapidly and 
more certainly cured on account of the increased power of 
reaction. Warm clothing, on the contrary, makes the skin 
delicate, flabby and flaccid, and produces the contrary 
effect. 

To make the children hardy, is not the only advantage 
of clothing them in this manner, but they gain, when com- 
pared with children brought up differently, in fullness, 
beauty, health, development of the organs of sense, and 



98 CLOTHING. 

of the limbs. Every one, no matter to what rank of society- 
he belongs, can afford to dress his child, in the above de- 
scribed manner, whilst the rich and fashionable will be fur- 
nished by the invention of the milliners and dress makers, 
with the means of increasing the charms of their children, 
even in this simple attire, by the richness of the stuffs, and 
the beauty of the style and cut. 

Having now described the advantages of this simple 
dress, I consider it my duty to point out the disadvantages 
of a piece of female attire, which has become so injurious 
and destructive to the fair sex, I mean, the corsets. In 
consequence of a vain and foolish error, that the smaller 
the waist of a young woman, the greater her beauty, the 
majority, notwithstanding constant warnings, are induced 
and frequently encouraged by their foolish mothers, to force 
their chest from infancy into a cuiras of whalebone, pro- 
vided in front with a steel busk, without considering the 
pernicious consequences of this habit. The chest, confined 
by these corsets, is not only prevented from performing the 
functions of respiration properly, whilst the lungs are forced 
upwards and cannot expand, but it is also interrupted in its 
growth, whereby it becomes smaller, and is out of prepara- 
tion to the rest of the body. The lobes thus compressed, 
are not capable of expanding sufficiently, and of receiving 
the blood which is carried to them in the quantities neces- 
sary for oxydation. This produces frequent congestion of 
blood to the head and the chest, which gives rise to perio- 
dical headaches, asthma, tedious catarrh, tubercles on the 
lungs, cough, accompanied by spitting of blood, and con- 
sumption (phthisis pulmonalis). The development of the 
female breast is prevented by this constant compression, the 
lacteal vessels and ducts are not only prevented from ex- 
panding, but actually contract and finally become impassable, 



CLOTHING. 99 

wherefore among the higher classes, we find so many ladies, 
who in consequence of defective formation of the breasts 
and of the nipples, or for want of milk, are incapable of 
suckling their children, and so many, who suffer from pul- 
monic affections. In the same manner, as by the violent 
lacing of the upper part of the stays or corsets, the organs 
of the thorax or chest are forced upwards, so by the lower 
part the intestines of the abdomen are forced down, towards 
the pelvis, and by the constant painful covering of the ab- 
domen, a strong perspiration is sustained. The walls of the 
abdomen, as well as the ligaments of the uterus relax, which 
frequently causes, what is called, a pendulous belly. Be- 
sides this, the pressure of the intestines into the pelvis in- 
duces congestions in the lower part of the abdomen, and 
consequently, hysterics, spasms, irregular menstruation, 
green sickness (chlorosis), relaxation of the uterus, whites, 
miscarriages, swelled feet, etc., diseases, which, both with 
mothers and young women, terminate either in sudden 
death, or protracted sickness. 

Oh ! that mothers and daughters would take an example 
by such cases, of which they will find instances in every 
family, and instead of this coat of mail wear a simple 
bodice, seven or eight inches wide, made of India rubber, 
without any whalebone or iron busk, which can be fastened 
to the body of the dress. 



EXERCISE. 

As in the first months of its existence, the growth of the 
child is far more rapid than afterwards, the body requires 
also the greatest compensation for this effort of nature, 
wherefore it remains during the greater part, in a state of 
repose, from which only hunger awakens it. But the more 
the body of the child increases in growth, the longer be- 
come the intervals, during which it does not sleep, and 
which later, it fills up with exercise and play. For this 
purpose the child should have a few play things, with 
which it may amuse itself in the beginning in the bed, and 
later, upon a carpet, spread on the floor. On fine spring, 
summp and autumn days, it may exercise in a free, open, 
grassy and shady spot, and enjoy itself to its heart's con- 
tent, and by stretching out its arms and feet, bending for- 
ward, extending head and body, tumbling about, grasping 
at things and trying to raise them, creeping, trying to rise 
on hands and feet, or by the assistance of some near object, 
attempting to get up, first practice its growing strength. 

By this means the bones obtains their proper position, 
the muscles and sinews their requisite strength, and the 
child grows both in body and mind, so much so, that in the 
fifth or sixth month, such a child is able to keep itself erect 
and to move about, for we must not imagine that the 
transition from lying to walking should take place sud- 
denly, nor that we should not let the little creature out of 
bed, or out of our arms, before he can walk ; this is a mis- 
take, for we can only attribute the early standing and 
walking of a child to having allowed it to exercise its 
strength at will. 
1 00 



EXERCISE. 101 

If the child is to acquire strength, the free play of its 
muscles, constant exercise and uninterrupted activity, are 
absolutely necessary ; in our modern nurseries, where every 
breath of fresh air is excluded, where the wholesome air is 
tainted by perfumes and fumigations, where every breath, 
every motion of the child is watched, w r ith the eyes of Argus, 
and it is allowed no exercise, the acquirement of strength 
is impossible. 

If we were to compare a child, which, although begotten 
by young and healthy parents, has, at the age of three 
months, in consequence of the above described mummifica- 
tion, not yet obtained the free use of its limbs, can scarcely 
keep its head erect on its shoulders, sits squeezed and dou- 
bled up in a chair, made on purpose, in such a manner that 
the bones of the pelvis obtain an improper position. I say, 
if we compare such a creature, with a child of the same 
age, belonging to one of the savage tribes, or to one born 
on the Alps, how great would be the difference ! And 
should this not teach us not to attempt to tinker at the 
works of nature, but to strive to rear our children more in 
accordance with her laws, that both soul and body may not 
be lost. 

We have, however, no occasion, to seek for instructive 
examples in the system of rearing children among savage 
nations ; we can find plenty of them in the poorer classes, 
particularly among the inhabitants of the mountains or 
highlands. For with the latter as well as with the former, 
the mother leaves the child entirely unrestrained, with the 
exception of putting on a navel-bandage ; she takes it with 
her into the fields, lets it creep about as it likes, upon the bare 
ground, without any shoes or stockings, nay often allows it 
to run about in a mere gown or shirt. The consequence of 
this is, that these children, both in their youth and old age, 

9* 



102 EXERCISE. 

can brave every kind of weather and every kind of hard- 
ship, that the young men can perform the hardest kind of 
work, under the greatest deprivations, whilst one of our 
effeminate, city-reared dandies, sickens at the smallest blast 
of cold wind. If I wanted to enumerate all the errors and 
sins, which are committed in the rearing of children, the 
space allotted to this book, would never suffice. I shall 
merely notice, what must be forever banished from the 
nursery and the care of children, if they are to increase and 
grow in body and mind, the pride of their parents and of 
others. 

First, away with the wrapping of the child in so many 
swathes, swaddles, bands, and bandages, which, as I have 
shown most fully, must injure the constitution of the child. 

Secondly, burn the child's chair — the development of the 
muscles of the child is very slow, and the child is forced to 
sit much too early. It can scarcely keep its head erect, and 
if, therefore, it rests its chest against the front-piece, it may 
easily become crooked, particularly, if the child is not 
strong. In consequence of the round opening in the chair, 
into which the breech is forced, the delicate bones of 
the pelvis are easily bent into an improper position, for 
which, in particular, delicate girls are sure to suffer in their 
first confinement, if not sooner. Besides, these chairs, on 
which children are forced to sit, easily give rise to accidents ; 
the board in front may be displaced, and the child fall out 
on the floor, breaking its bones, suffering from concussion 
of the brain, and perhaps becoming lame. All this will be 
prevented by allowing the child to move about upon the 
ground, unrestrainedly, as has been mentioned before, and 
putting it to sit only, from time to time, when of its own 
accord it tries to do so. This, in the beginning, may be 
done, whilst the child is being fed ; it may then be placed 



EXERCISE. 103 

in the lap of the mother or nurse, and supported by the 
arm. 

The third evil is the go-cart and the leading-string, for 
thereby the chest is placed in a hanging position, and is 
also compressed. The body, in a manner hangs on the go- 
cart or leading-string, whereby the shoulders are pushed 
upwards, which, as w^ell as the flexible spinal column, may 
easily become crooked. The soft bones of the legs bend 
under the heavy-headed or thick-bellied child, and turn 
either inwardly or outwardly, the walk of the child, from the 
circular swinging motion, becomes tottering, uncertain, so 
that, when two and three years old, the poor little creature 
is not able to step over the most insignificant obstacles, 
without the assistance of its nurse. If, besides this, the 
nurse is in the habit of taking, or dragging the child by 
one hand, dislocation, spraining and ruptures may be the 
consequence. 

Therefore, let the children begin early to move about the 
floor by themselves, and when their strength increases, they 
will begin to walk almost without any assistance. If, 
however, the mother is too much afraid, that the child may 
fall, let the child's maid or nurse cower down upon the 
ground, a few paces from the child, and let her make the 
child run towards her, so that she can catch it, if it should 
stagger in the least ; this should be done by placing both 
hands under the arms of the child. By degrees this dis- 
tance must be increased, and at last the child may be led by 
one hand, whilst with the other it holds on to the objects 
about the room. 

As the senses become more perfect, the inclination to play 
arises in the child, which first manifests itself by the motion 
of the hands and feet, therefore, it should always have its 
hands free. The more the powers of the organs increase, 



104 EXERCISE. 

the more the child, from the mere looking at the surround- 
ing objects, proceeds to handle them, and to play with those, 
which its hands can reach. It soon begins to show a pre- 
ference for those persons who are always with it, tries 
to lisp the words, they utter, until it produces single 
sounds, w T hich, by degrees, become perfect words. 

At the age of eight years, the children ought to be in- 
structed in gymnastics, because by this means not only the 
physical, but also the mental faculties improve, for we do 
not seldom find, that where attention is paid to mental cul- 
tivation only, it proceeds very slowly, mechanically, and 
requires great exertion, under which the body not seldom 
sinks. But these gymnastic exercises are not only neces- 
sary to unfold the powers of the body and mind in youth, 
they also in after-life are of infinite service under different 
circumstances. 

One of these, as we have mentioned before, is, undoubt- 
edly, sw T imming, which the boys, according to their consti- 
tution, should, however, not begin until the eighth or 
tenth, and the girls not until the tenth or twelfth year. 
Important and necessary, as bodily exercise is for the be- 
fore mentioned purpose, we should always pay attention, 
1st, that these exercises are not always the same ; 2dly, 
that they are not undertaken too early, and not continued 
too long, because only, manifoldly varied motions of the 
limbs and muscles can be beneficial, whilst too early, too 
long continued, uniform exercises always become injurious, 
the ends of the bones in infancy being still cartilaginous, 
and when the muscular power is small, subject to bending, 
inflammation, and swelling. 

Uniform motions, for instance, constant walking, fatigue 
single parts too much, and give rise to inflammation in the 
articulations (joints). As to dancing, both young men and 



DISEASES OF CHILDREN IN GENERAL. 105 

young women are carried away by the excitement, and do 
not feel the determination of blood towards the lungs, want 
of breath, and oppression on the chest, until they are pre- 
vented from continuing to dance, the consequences of which 
are frequently, hemorrhage, and inflammation of the lungs, 
coughing up of blood, tedious catarrhs, asthma, etc., and 
with young females, who lace tightly, even death. 



DISEASES OF CHILDREN IN GENERAL. 

No medical subject has, within the last fifteen years, re- 
ceived so large a share of attention, as the diseases of chil- 
dren. Much good has resulted from this, as far as the 
diagnosis of these diseases is concerned ; but for their treat- 
ment, there remains still a void, which can only be filled 
by a simple natural method, which agrees with the child's 
development, a subject to which, unfortunately, but too 
little attention has been paid. 

I am far from capable of filling this great void, and can 
only express the heartfelt wish that others, by proposing a 
correct natural treatment, may succeed in arresting the 
great mortality and sickness of children. I can do nothing 
towards it, but contribute my twenty-two years' experience, 
in the most conscientious manner. 

By the name of diseases of children, I understand, in 
the first instance, such as are the result of the peculiar 
physical constitution of the child, to which I reckon those, 
which it brings with it into the world, namely : defective 
conformation of the tongue, harelip, dropsy in the head, in- 
duration of the cellular tissue, webbed fingers, and the like. 
Next those which make their appearance soon after the 
child is born, as : inflammation of the eyes, diseased al- 



106 APHTHA OR THRUSH. 

veolar processes, hydrocephalic affections, frequent inflam- 
mation of the trachea (tracheitis), bronchitis, atrophy 
(emaciation), scrofula, rachitis, crusta lactea, etc. Se- 
condly, those diseases consequent upon the period of de- 
velopment, in which the physician ought to pause before he 
interferes with medicines, because thereby the whole pro- 
cess of development may easily be interrupted, whilst the 
diseases, under proper diet, exercise, fresh air, and other 
natural care, would disappear soon and with certainty. 

The third are acquired diseases, which I shall try to re- 
present one after the other, in relating the history of ac- 
tual cases, which I have treated in a manner agreeable to 
nature, in order to make known their method of treatment, 
and the success which has attended it. 



APHTHA OR THRUSH. 

Thrush is a disease which occurs very frequently with 
new-born infants, and consists of numerous minute vesicles, 
resembling white millet seeds, which are situated in the 
mucous membrane, mostly in the mouth and the gullet, and 
thence spread through the throat over the whole alimentary 
canal down to the anus. These vesicles, which frequently 
exist in great masses, open and eat deeply into the mucous 
membrane, which at those parts appears white, surrounded 
by inflammation, and spongy. By this means, it becomes 
very difficult for the child to suck, to swallow, and even to 
digest, and when the thrush becomes excessive, it is almost 
impossible, in consequence of which the child falls away 
very much. It is uneasy, sleeps but little, tosses about, 
takes the breast of the mother only for a short time, and 
screams incessantly, which often induces the mother and 



APHTHA OR THRUSH. 107 

the nurse to take this disease for one entirely opposite ; 
wherefore it is advisable, not only as soon as the disease 
makes its first appearance, but at all times, to examine the 
mouth daily, in order to take the necessary steps as soon as 
the first symptoms begin to show themselves. 

The causes of this common evil are : uncleanliness, im- 
proper diet during pregnancy and suckling, too much 
acidity in the first weeks, want of washing and bathing, 
and of fresh air ; damp, low dwellings, sucking-bags, etc. 
On first perceiving the existence of the evil, we should try 
to remove the cause, by bringing the child frequently into 
the fresh air, and if that is not practicable, by airing the 
nursery, by bathing the child twice a-day, in a temperature 
varying from 18° to 26° Reaumur (72J° to 90|° Fahren- 
heit), accordingly, as the child is weak or robust ; too much 
heat would make the evil more complicated. The nurse or 
the mother should, frequently during the day, take a linen 
rag, steep it in spring or hydrant water, wrap it round the 
finger, and wipe the mouth of the infant. In case the 
thrush appears also in the anus, injections of water of from 
10° to 12° Reaumur, (54|° to 59° Fahrenheit), should be 
given. 

This treatment, more or less modified, has always cured 
this disease in a few days, without giving any aperient or 
other medicine ; but I invariably directed my first attention 
to the proper regulating of the diet of the mother or of the 
nurse. 



IMFLAMMATION OF THE EYES. 

One of the most important and most dangerous diseases 
of children, is the inflammation of the eyes (ophthalmia), 
.because next to the Egyptian ophthalmia, it causes most 
frequently, the loss of sight, and according to my own ob- 
servation, and that of other physicians, is an evil, which seeks 
out the huts of the poor, and fills two-thirds of the institu- 
tions for the blind. 

_ The inflammation of the eyes, as well as the inflammation 
of the eyelids, the purulent eye, and gonorrheal ophthal- 
mia are diseases, which, at the slightest neglect, threaten to 
annihilate the sight, and which partly are brought into the 
world, partly obtained in passing through the vagina, or soon 
after being born, and of which the causes are generally to 
be found in the mother, particularly that of the gonorrheal 
ophthalmia. The causes which produce this evil, during 
the excessive activity of the process of formation in the eye 
of the child, when every exciting influence is followed by a 
most rapid development, are the female gonarrhoea, or ma- 
lignant fluor albus, and the innocent fluor albus, (whites), 
in which cases, the child is infected, whilst the head is pass- 
ing through the vagina. Also, the long compression of the 
head during labor, and violent delivery w T ith instruments, 
whereby frequent congestions towards the eyes are caused ; 
too strong a light, the cleaning of the eyes with the sponge 
with which the child was first washed, and which still con- 
tained some of the mucus, or w r ashing the eyes with the 
water ; a nursery, the air of which is infected by being pent 
up, and by malignant exhalations. 

Among the above enumerated causes, the worst always 
108 



INFLAMMATION OF THE EYES. 109 

remains, when it arises from actual gonorrhoea, bad or ma- 
lignant leucorrhoea ; in this case, the affection generally 
makes its appearance from the third to the seventh day, and 
if it is not immediately recognized, and a proper treatment 
commenced, in consequence of the rapid progress of forma- 
tion in the child, the transparent cornea (cornea pellucida), 
is destroyed in a few days by suppuration, and the child is 
blind for life. 

To prevent this misfortune, or at least to impede the rapid 
progress, w T e would advise all midwives to clear the vagina 
of all women, who are affected with leucorrhoea, a few mo- 
ments before the child comes into the w^orld, with clear 
hike- warm w T ater, and to wash the eyes of the child, as 
soon as born, carefully, with a sponge dipped in cold 
water, and kept in readiness for that purpose, which should 
be repeated several times a day. 

Particular care should be taken to avoid the other causes, 
above mentioned, as much as possible. 

After difficult labor, during which the head was a long 
time compressed by the small pelvis, as well as after deli- 
very with instruments, the nurse should immediately apply 
cold fomentations around the head, which, when the eyes 
begin to get red, should be placed also over these organs. 
These fomentations must always be made of fresh, cold, 
clear w^ater, and must, by no means, cause any pressure, 
wherefore, they should be made of old linen, folded three 
or four times. 

Every time the cloths get warm they should be changed. 
If, in spite of the constantly applied fomentations, the lids 
of the eyes begin to stick together, add to the water one 
quarter of pure, skimmed, sweet cow's milk. In this case 
the fomentations are not renewed so often, care being taken, 
however, that the cloths do not get dry. 

10 



110 INFLAMMATION OP THE EYES. 

When the skin is very red, and the head hot, and spe- 
cially when, with the affection of the eyes, thrush makes 
its appearance, besides the fomentations over the eyes, 
cold fomentations over the whole head should be applied, 
and the child be bathed, two or three times, every twenty- 
four hours, in water of 18 to 20° Reaumur (72§ to 77° Fah- 
renheit.) The mother should keep a strict diet, give the 
child the breast as seldom as possible, but let it often drink 
of luke-warm water and sugar. 

HISTORY OF THE DISEASE. 

Anne Streit was born on the 9th of May, 1842, perfectly 
healthy, stout and full grown ; the father was in perfect 
health, but the mother weakly, scrofulous, and of a pale, 
puffed-up complexion. The parents, as well as the mid- 
wife, asserted to have perceived no trace of sickness, gene- 
rally, nor during the first five days of its existence, any 
affection of the eyes. Not until the fifth day, in the eve- 
ing, did it appear, that the little girl had become somewhat 
shy of light, and on the sixth day, in the morning, and 
later, after every nap, that the lids of the right eye were 
adhering partially, which soon, also, appeared in the left 
eye, so that, on the eighth day, the lids remained convul- 
sively closed nearly the whole time, and tears frequently 
escaped from the eyes, which afterwards made the cheeks 
red. On the ninth day, the nearest physician was called 
in, who, notwithstanding leeching, purging, and the appli- 
cation of eye-water, could not check the disease. 

On the fifteenth day after the child was born, therefore, 
on the tenth day, after the commencement of the disease, I 
was called in, when I found besides considerable jaundice, 
a generally heightened temperature, particularly in the head, 



INFLAMMATION OF THE EYES. Ill 

both eyes closed, the lids, which, to the orbital margin were 
swelled, oedematously (watery), were glued together by a 
yellowish crust, and the cheeks excoriated from the flow- 
ing tears. On forcibly opening the eye-lids, both the con- 
junctiva palpebralis (lining membrane of the lids), and 
the conjunctiva adnata (investing membrane of the 
eye-balls), were inflamed, flesh colored and swelled, and 
between the lids of both eyes there was an accumulation of 
yellow pus ; the pellucid cornea, as if covered with a film, 
and interwoven with a fine reddish net, but the crystalline 
lens darkened, a visible exacerbation taking place twice a 
day. 

Application of a pad, of fine linen, was made to the head, 
and of two smaller ones to the eyes : they were changed as 
often as they became too hot, the whole child w r as wrapped 
in cloths, which had before been steeped in cold water and 
then wrung out well, those were changed as often as they 
became dry ; after which, the child was placed, every time, 
for six minutes, in a bath of 16° Reaumur (58° Fahrenheit), 
and already, on the third day, the rapid progress of the 
disease was checked. This treatment was continued, and 
when the inflammation and fever had abated, the fomenta- 
tions and enveloping were applied less often. In six days 
it had recovered the faculty of vision entirely. During the 
time of this treatment, the eyes and cheeks of the child 
were washed, as often as possible, w r ith luke-warm milk 
and water ; the mother was kept on strict diet — the breast 
given to the child only four times a day, rather sparingly, 
and luke-warm w T ater, with sugar, allowed as a drink. 



TONGUE-TIE. 

As soon as the child has been washed in the first bath, 
and the mouth has been cleaned, the nurse should try im- 
mediately, whether the child is tongue-tied, by inserting the 
little finger under the tongue, trying to lift it up. If this 
cannot be done, without any difficulty, the child is tongue- 
tied, which can also be seen every time it cries. By 
means of the froenum (band or ligament) the tongue may 
be partially or entirely fastened to the apex (point), by 
which, crying, and particularly sucking and swallow- 
ing, is made almost impossible. 

In this case, we should immediately send for a skilful oper- 
ator, or surgeon, and have the tongue loosened. But in cases 
w T here it is only partially fastened, does not interfere with the 
functions of the child for the moment, and might, only later, 
prevent its speech, we may postpone the operation, trying 
from time to time to push back the ligament with the little 
finger, round which a strip of fine linen has been tied, and 
which has been steeped in cold water ; generally this is 
successful, after a while. But, if in eight or ten weeks, 
this cannot be effected, we must, also, have recourse to the 
operation. After it has been performed, the mother or the 
nurse should, immediately, give the breast to the child, and 
in case the bleeding is considerable, she should place the 
finger, enveloped with a wet linen rag, as described above, 
en the bleeding spot, until it stops entirely. 

112 



THE TAPE-WORM. 

We seldom find a man, who, for the whole course of his 
life has been free of worms. They always take their seat 
in the digestive organs and intestines, and children are par- 
ticularly troubled with them. 

Of the many kinds of boarders which dwell in our intes- 
tines, the tape-worm is the most dangerous, particularly 
during the tender age of infancy ; not only because it is the 
largest intestine worm, but also, on account of its motion, 
its rapid growth, and because it deprives the child of too 
much of sustenance, and of the mass of the juices, for its 
own support. The consequences of the presence of the 
tape-worm are : colic, vomiting, spasms, epilepsy, decline, 
and even death. These attacks, in conjunction w T ith the 
effect of the so-called Drastica Roberantia, and other medi- 
cines, consume the vital powers, or in the most favorable 
case, leave behind constant sickness. 

In my experiments of treating different diseases with 
water, I became convinced that, also, in cases of tape- 
worm, it possesses a sanative power, because, without any 
further application, it drives off or kills and dissolves the 
worm. Out of many cases, which I have treated since ] 828, 
I select the following : 

David Klein, a child eight years old, of weak limbs, de- 
licate and sensitive, of scrofulous appearance, possessed a 
determined worm physiognomy. The boy had suffered for 
a year of colic-like cutting in the bowels, which was to be 
allayed only by a couple of cups of warm milk. After 
some time, when several antidotes had been taken, and some 
maw- worms had been passed, symptoms of tape-worm ap- 

10* 113 



114 TAPE-WORM. 

peared, against which war was declared in different ways, 
but in vain. Three months after this, the boy was intro- 
duced to me. His face was puffed up, of an earthy color, 
the belly high, hard and painful to the touch ; the other 
parts of his body, notwithstanding a good appetite, much 
emaciated, his whole appearance indicating great suffering ; 
slimy diarrhoea was succeeded by sudden vomiting, after 
w T hich the patient was well for a few days. 

After having confined his diet to pure fresh milk and 
acid fruit, I ordered a four-fold broad bandage, which had 
been steeped in cold water and been wrung out, to be 
worn permanently around the whole of the abdomen, over 
which a second dry one was to be placed. The bandage 
had to be changed whenever it commenced to get dry. 
Further, I had the boy enveloped every morning and every 
evening in a wet linen sheet, not wrung too much, and let 
him lie in it until perspiration appeared. I then had him 
put in a bath of 8° Reaumur (50° Fahrenheit), until chills 
came on, and had his feet and lower part of the abdomen 
well rubbed, while in the bath. After the chills appeared, 
the boy was taken out of the bath, and, in the beginning, 
half a gallon, later, three gallons of water quickly poured 
over the lower part of the abdomen, so that the thin ray 
touched every part of the walls of the abdomen ; where- 
upon, after the wet bandage had been replaced around the 
belly, the boy was put into bed again, and covered well up. 
The first two days, I made the patient drink cold water, 
once ; the third and fourth clay, twice ; and later four times 
a day, until vomiting ensued ; observing, exactly that these 
drinks were always taken only an hour before, or after, the 
prescribed food, which was done in the morning and evening 
at six, and in the day-time at twelve o'clock. 

Already during the first days, the cutting pains in the 



CROUP. 115 

bowels ceased ; on the seventh day of this treatment, a 
rumbling commenced, which, at intervals, lasted until the 
eleventh day ; on the thirteenth day, in the afternoon at 
three o'clock, the patient after pouring down the third glass 
of cold water, w r as attacked with vomiting, and at the same 
time with a violent inclination to stool, when after passing 
much tough phlegm, in lumps, finally the long-wished for 
tape-worm made its appearance, measuring eleven and a 
half yards in length. As the head of the beast had been 
passed, I allowed the boy to leave off drinking the water, 
and also omitted the affusions, confining the treatment to 
two hip-baths and the wearing of the wet bandage. As on 
the fourteenth or fifteenth day of the treatment, a number 
of small joints of the worm were voided, and no further 
bad symptoms appeared ; I ordered the boy a nourishing 
meat diet, which was to be increased in quantity and in 
quality, after which, continuing the cold washing morning 
and evening, he was running about perfectly well three 
weeks after, and is still, eight years later, perfectly sound 
and healthy, without having ever been troubled again by 
his old complaint. 



CROUP. 

This is a disease by which children are frequently 
attacked, which often appears as an epidemic, and which, 
notwithstanding all that has been written about it, carries 
off, at least one-third of the children which are attacked. 
Among the writings on this subject, I cannot help recom- 
mending the work of Dr. T. J. Lauda, in Prague, on the 
hydropathic treatment of this malady ; this work has not 
received the attention which it deserves ; people still prefer 



116 CROUP. 

blisters, mustard and horse-radish plasters, leeches, setons 
calomel, jalap, emetics, squills, digitalis, preparations of 
ammonia, copper and zink, and rather let their children die 
under the application of tracheotomy (opening of the wind- 
pipe), then save them without any medicines. 

Any one who has had an opportunity of observing a chile 
during the course of this disease, will never forget its ap- 
pearance. 

Just as easy is it to recognize the disease, when we know 
that it is a peculiar inflammation of the larynx and the 
wind-pipe, which, with the swelling in the organs situated 
there, principally of the mucous membrane, the accumula- 
tion of mucus, and the exudation of a peculiar skin called 
the pseudo-membrane, narrows, nay, often closes those 
parts entirely, through which respiration is accomplished. 
The symptoms of the disease are so distinct, that every 
practical physician will recognize at once, not only the dis- 
ease itself, but also its stage. For the layman, for whom 
I principally w r rite this work, it may be different. I shall, 
therefore, divide it into three stages, and represent these in 
relating the history of different cases, for the information 
of those who are not of the profession, whilst I add their 
treatment according to my own experience. 

COMMENCEMENT OR FIRST STAGE OF THE CROUP. 

The child of Joseph Weil, a weaver in Bilitz, a boy seven 
years old, fair, strongly built, well fed, and of rather an 
indolent temperament, was, in consequence of a cold, which 
he had caught in the snow on the 24th of January, attacked, 
first by chills, then by heat ; as the latter increased, and 
the child began to get hoarse, the parents sent for me early 
on the 25th. 



CROUP. 117 

The mother informed me that the child had slept very- 
uneasy , had often screamed, often asked to drink, but as 
she had been afraid that the cold might hurt, had given a 
warm marsh-mallow tea, which after a while, the child had 
rejected. After midnight the boy had become very hoarse, 
and the heat had increased to such a degree, that she had 
lot been able to keep the child in bed with her, where it 
was in the habit of sleeping. 

The face of the child, which was tossing about in the 
)ed very uneasily, was puffed up and very red, the whole 
)ody, particularly the head, neck and face, burning hot, 
swallowing difficult, the larynx very painful at the least 
pressure ; frequent painful hemming, accompanied by hollow, 
sharp cough which came on by starts, resembling a bark, 
md, from which, when I listened attentively, I- concluded 
that the respiration was low, but somewhat sharp and 
lard. 

After much persuasion, and after having represented to 
the parents, that by the application of cold water, the 
child would recover certainly and quickly, they at last con- 
sented to this treatment. 

We placed the boy into a tub, w r hilst the skin was at a 
temperature of 32° Reaumur (104° Fahrenheit), and with 
a linen rag dipped in water of 6° Reaumur (45|° Fahren- 
heit), the aunt and I washed him three times in succession 
for a short minute, he was then, wet as he was, wrapped in 
a single linen sheet, which had been dipped in the same 
water and been slightly wrung, and was then put to bed 
and well covered up. On the head and neck cold fomenta- 
tions, covered with dry cloths, were applied, which had to 
be changed every quarter of an hour, whilst the child, 
whenever it wished for a drink, was allowed to take small 
quantities of cold water. 



118 CROUP. 

During these proceedings the child behaved very impa- 
tiently, kicking with hands and feet, and crying most 
lustily ; but when once enveloped in the wet sheet, it be- 
came quiet, notwithstanding the chill which soon com- 
menced. The temperature of the skin had nearly fallen one- 
half, breathing become easier, and after half an hour, the 
child fell asleep and continued to sleep quietly for an hour 
and a half. As, during this time and afterwards, the heat 
of the body, and the heavy hoarse breath increased again, 
and I found the sheet to have become quite dry, the skin 
continuing dry, without any disposition to perspire, we 
placed the little fellow, without first washing him, in a 
second sheet, which was wrung as much as the first, and 
proceeded otherwise, as before. 

As soon ^s the chill, caused by the wet sheet, was over, 
the child fell asleep quietly, the heat decreased perceptibly, 
breathing became more free, and at twelve o'clock, about 
two hours and a half after putting on the sheet, for the last 
time, a light perspiration appeared over the whole body. 
About half an hour after the commencement of the perspi- 
ration, the child awoke, was cheerful, and the hoarseness 
had so far disappeared, that it could be perfectly under- 
stood, when it spoke. But as the child got uneasy after 
this time, and would not remain in bed, the parents asked 
me to see it again. With the intention of leaving the 
child in the perspiration, I did not go until one o'clock, 
and found it bathed in perspiration, the respiration quite 
free, and the voice very little hoarse. Consequently, I did 
not fail to take the child out of bed, and to wash it, like 
the first time, but with water of 12° Reaumur (59° Fahren- 
heit), and very quickly, to wrap it wet in a dry linen sheet, 
place it into the bed again, and have the former fomenta- 
tions around head and neck repeated alternately. Scarcely 



CROUP. 119 

was the little fellow in bed, when during an attack of 
cough, he threw up a quantity of tough, white mucus, and 
the mother told me that before my arrival, he had thrown 
up a similar quantity. 

I left directions with the parents, in case the heat should 
return, to wrap the child again in a wet sheet, and when the 
perspiration had lasted about as long as the first time, to 
proceed as before. At my call in the evening, I learned 
that the child had perspired considerably, it was cheerful, 
and with a much increased temperature of the body ; the 
swallowing was easy, and, as the child demanded something 
to eat, I allowed cold boiled milk to be given. I recom- 
mended the parents to continue the cold fomentation of neck 
and head, to give frequent cold drinks during the night and 
every time it should begin to be uneasy, and the heat 
should return, to wash in fresh water. The next morn- 
ing, I found the child up, merry and well, and I merely 
prescribed diet, to remain a few days in the room, and to be 
washed two or three times a day in water of 15° Reaumur, 
(65 1° Fahrenheit). The boy soon recovered, and on the 
fifth day, was running about in the street, as well as ever. 

CROUP IN THE SECOND STAGE, OR STAGE OF PERSPIRATION. 

Julia Shine, five years of age, daughter of a locksmith, 
in Neukirchen, a very pretty, fair haired, little girl, was at- 
tacked by violent chills, in consequence of a previous cold, 
which she had caught, by escaping from her mother, just 
after having taken a warm bath in the morning, and running 
out into the open air, when the Thermometer stood at 18° 
Reaumur, below the freezing point, (8|° below zero, accord- 
ing to Fahrenheit) ; to these chills soon came hoarseness. 
When the parents perceived this, they thought to prevent 



120 CROUP. 

the attack, by putting the child into bed, and giving it 
plenty of warm alder tea, and pictoral tea. As by this 
means the chills passed off, and after a few hours the child 
began to perspire, the parents thought that it would have 
no further bad consequences, and when the child wished to 
get up, allowed her to do so, and to run about the room ; 
a few hours after she was again in the street. During the 
same night, the mother perceived that the child was uneasy, 
and that it coughed often ; and, when these symptoms to- 
wards morning increased, and the temperature of the body 
rose, the mother thought that it would do good to produce 
perspiration again, by giving the child plenty of alder tea, 
and by applying leaven of rye flour to the feet, to dimin- 
ish the heat. As I w T as told, the child drank with consi- 
derable reluctance, a quantity of this tea, but, notwithstand- 
ing this, and although the mother did not leave the bedside, 
and the child was well covered, the heat, hoarseness, and 
hollow cough increased constantly. Towards the morning, 
the child began to perspire slightly, fell asleep, but soon 
awoke again with a scream. 

This state continued, with increasing heat of the body, 
and uneasiness, and as towards morning, the loth of March, 
the child slept at short intervals, whilst, as they told me, it 
w r as breathing, with a rattling noise in the throat, and every 
time awoke suddenly from its sleep with a cry, was hoarse, 
and obliged to cough, whilst it wept and screamed, the 
parents were induced to send for me. 

I found, although the body was hot and dry, that the 
forehead was covered with perspiration, that the face was 
puffed up, the cheeks, lips, tongue and throat very red, the 
look sharp, and the eye glistening with a peculiar bright- 
ness, the breath very hot, the pulsation of the external jugu- 
lar vein and of the heart visible at a distance, the tempera- 



croup. 121 

ture of the body burning hot, at the same time, respiration 
very difficult ; whilst the motion of the chest was very per- 
ceptible, accompanied by a fine, hollow, hissing, whistling 
tone, w T hich could particularly be heard when the child 
inhaled. 

Its sleep was uneasy, it tossed about, awoke suddenly 
during a violent attack of coughing, and screamed aloud. 
The cough was dry, hollow, barking and shrill, so that it 
could be heard far off. 

I recognized the case as one of croup, in the highest stage 
of inflammation, with disposition to perspire. Considering 
the overcoming of the inflammation as most important, I 
immediately ordered, whilst I lent myself a helping hand, 
a quick washing with water of 5° Reaumur (43|° Fah- 
renheit) ; hereupon, wrapping the child in double wet linen 
sheets of the same temperature, then enveloping it in dry 
cloths ; putting a bladder, filled w T ith ice, over the head, 
neck and throat, and plenty of drinking, although the child 
found it so difficult, that, notwithstanding the burning fever, 
it every time pushed away the cup, and every time it swal- 
lowed some, screamed aloud. This, however, yielded so 
far, after several attempts, that in half an hour it succeeded 
in swallowing a teaspoonful, at short intervals. 

These washings, I had repeated, whenever the heat re- 
turned, which I found necessary every three hours. The 
application on the neck and head were renewed, whenever 
the ice was melted ; not until the fever had considerably 
abated, the child had become more quiet, the breathing was 
freer, I let it lie, after it had been washed at seven o'clock 
in the evening, in wet sheets, till perspiration broke out, 
which took place three hours after ; when this had become 
general, and had lasted half an hour, the child was taken 
out of bed, placed in a bathing tub and washed rapidly 

11 



122 croup. 

with water of 10° Reaumur (54 J° Fahrenheit). After this 
it was wrapped wet in a dry sheet, placed in bed, and the 
application of ice to the head and neck continued, where- 
upon it soon became more quiet and fell asleep. But as 
the symptoms towards twelve o'clock became worse again, 
the child after having been washed as before, was wrapped 
in wet sheets and left in them to perspire, which took place 
at one o'clock P. M. most copiously. Hereupon the child 
became quiet, the heat was inconsiderable, breathing free, 
the cough less frequent, and with little effort, it vomited a 
very tough mucus. We now let the little girl perspire 
abundantly for two whole hours, and then washed her as in 
the morning. On the 17th at seven o'clock in the morn- 
ing I found the child sleeping quietly in its night-clothes, 
in the lap of the mother ; the heat had vanished from the 
head, face and throat, respiration was free, the tone on in- 
haling not yet quite clear, the temperature of the rest of the 
body but slightly increased, but the skin moist and soft. 
The mother told me that the child had had two copious 
stools during the night, that it had slept since four in the 
morning, had only coughed a couple of times, and every 
time vomited about two table-spoonfuls of tough mucus ; 
that the heat had not returned since eleven o'clock of the 
preceding evening, and that therefore she, the mother, had 
not hesitated to fulfil the wish of the child, to take it on her 
knee, when it awoke half an hour ago, where it soon 
had fallen quietly asleep again. I prescribed to wash the 
child every four hours over the whole body, to wrap it wet, 
well up in its bed, to make cold fomentation with linen 
cloths, dipped in fresh hydrant water of 6° Reaumur, 
(45|° Fahrenheit), and lightly wrung, to renew it as often 
as they became dry, and to give the child thin barley water 
in small quantities. 



croup. 123 

In the afternoon at four o'clock, of the same day, the 
child was lively and well, swallowing and breathing free, the 
cough inconsiderable, only the voice continued somewhat 
hoarse and the temperature of the skin still somewhat 
heightened. I merely ordered washing at 12° Reaumur, 
(59° Fahrenheit), and if perspirations should ensue during 
the night, repetition of the same, but in water of 15° 
Reaumur (65|° Fahrenheit), and continuation of the fo- 
mentations around the neck, but which now should be 
changed less often, and be made with water of 12° Reau- 
mur (59° Fahrenheit). 

The night was passed by the child in constant sleep with 
short intervals. I found the little girl awake, cheerful, 
playing with her little sisters, and besides the paleness of 
her cheeks, could perceive no sign of sickness on her. To 
keep the activity of the skin in the same state, I ordered 
her to be washed twice a day for a minute in water of 15° 
Reaumur (65|° Fahrenheit), and to wear round the neck 
for two days longer, wet cloths of the same temperature ; 
with these the child ran about the room, and on the sixth 
day after the commencement of the disease, was able to go 
out with the mother. 



CROUP IN THE THIRD STAGE, OR THAT OF SUFFOCATION. 

Clara Fischer, the daughter of a justice of the peace 
in Neukirchen, three years of age, a dark brunet, heretofore 
in good health, well fed, the only child of parents in very 
good circumstances, was in the month of September, 
during the vintage, carried by her grandmother to the vine- 
yard, where the child remained, playing in the grass until 
the evening. As a sharp north-easterly wind was blowing 



124 



CROUP. 



that day, and the child had been playing for several hours 
in the damp cold grass, it was taken with a fit of shivering. 
The grandmother, when bringing the child home, thought to 
do it good, by letting it sit beside the hot stove in the ser- 
vant's room, in which from the presence of a great many per- 
sons, and the preparations of the evening meal the heat and 
steam were very great. The child fell asleep, and four hours 
after awoke with a violent cough and heat. During the same 
night the child was very uneasy, the next morning rather 
hoarse, cross, hemming frequently, and coughing with a 
shrill tone. During this day, the child had to be carried 
about, at two o'clock in the afternoon had chills, then 
fever, after w^hich the hoarseness increased considerably and 
the cough became shriller and deeper. 

As the parents of the child took the indisposition for a 
cold, which would pass off, they merely gave her some 
cough and catarrh lozenges, and in the evening some warm 
milk with egg and sugar. The child however only slept 
for short periods, became more and more uneasy, screamed 
frequently, whilst the breathing became more audible, and 
the heat of the body increased to such a degree, that the 
mother thought the child was all a fire. Towards morn- 
ing it would not stay in bed any longer, but persisted in 
being carried about in the room by the mother, and would 
not allow any one to come near it, found rest nowhere, fre- [ 
quently bent backwards, and had several attacks of suffo- 
cation after midnight. 

Alarmed for the life of their child by the rapidly increas- 1 
ing sufferings, the parents sent for me on the 24th of Sep- 
tember, before the morning dawned. 

After the mother had related to me what has alreadyl 
been stated, I found the child, which a few days ago I hadl 
seen perfectly well, very much disfigured. The face wasl 



croup. 125 

bloated, the eye fixed, at the same time rolling wildly, the 
look glassy ; it gnashed its teeth, bent backwards whilst the 
mother held it in her arms, often looked round the room 
shyly and confusedly as if it were looking for somebody, 
and gasped for breath with an open mouth ; the tone when 
inhaling and exhaling was whistling, sharp and hissing, the 
child itself without any voice, the cough rare, trifling, and 
accompanied by an effort to prevent it ; when this did not 
succeed, it stretched itself, bent the head backwards towards 
the neck, gnashed its teeth violently, shut its little fists con- 
vulsively, the eyes became fixed, the lips blue, over the 
whole body a cold sweat appeared, the pulsation of the 
exterior jugular vein, as also the beating of the heart could 
be seen distinctly, breathing became deeper and rarer, and 
the chest rose to such a degree, and the abdomen was drawn 
in so far, that it left for a moment a hollow in the region of 
the stomach. This attack lasted for more than two min- 
utes, abated, after the perspiration had broken out, and the 
child sunk exhausted into the lap of the mother. 

Recognizing here, by the exudation which had already 
taken place in the larynx, the wind-pipe and its branches, and 
by the symptoms which threatened suffocation, that this was 
the third stage, I thought it most necessary to act energeti- 
cally and in such a manner, that the exudation, which 
threatened the life of the child, should be arrested or thrown 
off by an increased natural activity, particularly in the 
organs of the skin. After everything was ready, I ordered 
the child to be undressed, to have the perspiration wiped 
off, and to have it cooled by washing it with water a little 
tempered ; I then had it placed in a wash-tub, and got two 
women to hold it, after which I poured water over the 
child, by means of a vessel, which held about three gallons 
at 7° Reaumur (47 f° Fahrenheit), during eight min- 

11* 



126 croup. 

utes, in such a manner that I could partially hit the body 
in streaks, from the head to the feet downwards, but par- 
ticularly the head and neck, whilst I caused the breast, 
neck and limbs to be rubbed with damp linen cloths, after 
which the child was wrapped wet in a dry linen sheet and 
put to bed. 

During the affusions, which lasted about eight minutes, 
the child could scarcely be held, gasped for breath, and 
the whole body became blueish and distorted. As soon as 
it was in bed I had bladders, filled with pounded ice, 
placed on its head and around its neck, and ordered frequent 
drinks of cold w^ater to be given to the child, but which, in 
the beginning, she could not swallow. The chills and shiv- 
ering, consequent upon the affusions, had not yet disappeared, 
when the sick girl had already fallen asleep. At the same 
time breathing became more free, and after about half an 
hour the respiration took a rattling sound. This sleep lasted 
about an hour and a half, after w T hich the breath became 
again more whistling, and harder, the skin hotter and 
breathing more difficult ; wherefore three hours after, name- 
ly, near eight o'clock, I ordered the second affusions to be 
applied. Of these affusions eight were applied in 56 hours, 
at greater and greater intervals ; in the first five I used the 
same quantity of water in the same time, the sixth and 
seventh lasted only six minutes, and the eighth only four 
minutes. Already after the fourth affusion, on account of 
the decrease of the symptoms of the disease, the ice-blad- 
der was removed from the head, and after the sixth, that 
from the neck, instead of which linen compresses, steeped 
in cold hydrant water were tied round the throat. 

The child improved evidently, from hour to hour, and 
already on the 25th, in the afternoon, I allowed some cold 
boiled cow's milk to be given. 



croup. 127 

On the 26th, at six o'clock in the evening, after the child 
had perspired copiously, after the sixth affusion, as well as 
after the four preceding, the second, third, fourth and fifth, 
it was washed in water at 15° Reaumur (65| Fahrenheit), 
heretofore water of 10° Reaumur (54J Fahrenheit), having 
been used over the whole body. I directed the parents to 
continue the fomentations around the throat a few days 
longer, every time the heat should return, to wash the child 
in water of 10° to 12° Reaumur (54 J° to 59° Fahren- 
heit), to renew these ablutions as often as the heat of the 
body should increase, and not to give the child anything to 
eat but cold boiled cow's milk or barley water, and to offer 
it frequently cold water to drink. 

By this treatment, after a period of nine days, the little 
girl was as well as ever, and as early as the 1st October, I 
found her playing merrily with her companions. 

CROUP, ALSO IN THE THIRD STAGE, TERMINATING FATALLY. 

Frank King, not quite five years old, only son of a 
butcher, in very comfortable circumstances, at Schwaechend, 
was a fair, curly-headed, stout, blue-eyed boy. Playing in 
the yard in the wet, whilst it was raining, he had, accord- 
ing to the account of the physician of the place, who had 
treated him, caught a bronchial-catarrh, which the parents 
had neglected, so that on the evening of the third day, it 
turned to croup. This increased to such a degree, that 
when on the 28th April at nine o'clock, A. M. I was called 
to the sick child, I found a case, the symptoms of which 
were as dangerous as those of the last described, on account 
of the similarity of the two cases and their dissimilar ter- 
mination, I am obliged to mention this case here again. 



128 



CROUP. 



After the attack of suffocation, at which I was present 
with the physician, who had treated the child before, was 
passed, I had the affusion applied to the boy with the same 
precaution and under the same circumstances as in the for- 
mer case, I then caused him to be put to bed, in which the 
same became more easy ; whilst the chills still continued, 
he fell asleep, and remained so for about an hour and a 
half. 

The second affusions had to be applied, when scarcely 
two hours had elapsed, namely, at half past twelve P. M., 
because the heat and attacks of suffocation returned. Ha- 
ving carefully explained to the attending physician and the 
parents the necessary treatment, and recommended to them 
the affusions at every return of the heat, and attacks of 
suffocation, as well as the application of ice to the head 
and throat and the plentiful drinking of water, I left the 
little fellow after the third affusion, which had taken place 
at five in the afternoon, in a quiet sleep, and so much im- 
proved that I thought the greatest danger over, and in the 
expectation that my directions would be punctually 
obeyed. 

On the next day, the 29th, on account of a great number 
of patients, and the considerable distance of the place, I 
did not reach the house of the physician at Schwaechend 
until two o'clock P. M. He communicated to me that the 
child since my absence had slept well, and that the heat had 
not returned until twelve o'clock at night, after which the 
affusions had been repeated ; the boy had then fallen asleep, 
and had slept undisturbedly, until five o'clock in the morn- 
ing, perspiring regularly ; that the breathing had been but 
little obstructed, that the eye had been cheerful, and the 
voice intelligible ; that the child had asked to get up, and 
demanded to eat something, both which demands the pa- 



croup. 129 

rents, notwithstanding his advice to the contrary, had gra- 
tified. 

Thus carried in the arms of the mother about the room, 
resting with his face on his hands, on the shoulder of the 
mother, he suddenly perceived a slice of bread and de- 
manded it. The parents did not only not hesitate to give 
it to him, but also covered it with raw honey. However, 
the half of it had not yet been eaten, when the child sud- 
denly had an attack of cough and of suffocation. 

Now they sent in haste to the physician of the place, 
who attended immediately, and in whose presence the child 
vomited several pieces of the bread, it had swallowed, and 
in the course of three hours, had two attacks of suffocation. 
Although the physician advised the parents to renew the 
affusions which I had recommended, they were omitted be- 
cause he did not sufficiently insist, and when we both visit- 
ed the boy after two o'clock, I saw that he was irrecovera- 
bly lost. The immediate cause of his death, which took 
place at six o'clock in the evening, in consequence of a sud- 
den congestion, was undoubtedly the over indulgence and 
affection of the parents towards the child, and their great 
prejudice against the application of cold water. 

The above related case should therefore be a warning to 
every physician, who treats hydropathically or with water, 
a child which has croup to that degree, or any other dan- 
gerous disease, and who lives at a great distance, never to 
leave the child until the sickness is completely overcome, 
or a substitute is found, who is conversant with hydropathy, 
or the treatment with water. 



BOILS, (FURUNCULUS.) 

This is a very common disease, which generally proceeds 
from the person who suckles the child, from the sickly 
state of the mother when pregnant, or from the situation of 
the locality. It is produced by a peculiar bilious acrimony 
in the juices of the child, whose nature thus rids itself 
of them ; but even here we ought not to omit to aid nature 
in her effort, because otherwise these boils might begin to 
suppurate, become malignant, and even wear out the feeble 
strength of the child. 

Leopold Herz from Bruch, aged four months, strong and 
healthy, of sound and healthy parents, was suddenly at- 
tacked by boils after the mother had already been sick for 
four weeks with a bilious fever. The affection increased 
at such a rate in a fortnight, that when I was called, I found 
twenty-six of them, varying in size from that of a bean to 
that of a walnut, on the head, neck, back, and the joints 
of the arms and legs. The greatest number was on the 
head, and the largest was on the neck near the left shoul- 
der. Notwithstanding the emaciation of the child, in con- 
sequence of the unwholesome food and the violent pains, 
suppuration had already commenced, and the pus was very 
thin and liquid, on account of which, considering the re- 
duced strength of the child, the incessant pain, and the bad 
state of the milk, I feared the accession of a wasting 
fever. 

The child was immediately taken from the breast of the 
mother, and given to a neighbor, who had been delivered 
ten weeks ago, and whose child had died a few days since. 
This woman gave the child the breast four times a day, and 
in the intervals a soup of grated bread and the yoke of an 
130 



BOILS. 131 

egg and some water, also some fresh water and a little 
sugar was given to the child. The suppurating boils were 
covered with moist linen rags, but the whole body of the 
child was wrapped every four hours, consequently six times a 
day, in a fine wet linen sheet, and four hours after, washed 
in water of 16° Reaumur (63° Fahrenheit), equal to that 
in which the sheet had been dipped, after which the pro- 
ceeding again recommenced immediately. 

Under this treatment, which we continued without inter- 
ruption for a week, the appearance of the child improved 
evidently ; the boils, which had before commenced to sup- 
purate, became healthful, and healed up by the eighth day ; 
the remainder, of which the greater part discharged a thick 
bloody pus, had partly opened, partly dried up. 

On the ninth day of the treatment, the enveloping in we*t 
sheets was discontinued, instead of which resolvent appli- 
cations were made to those parts, w^hich were still covered 
with boils, these consisted of rags, doubled four times, 
steeped in water of 12° Reaumur (59° Fahrenheit), and 
well wrung, which were again covered with dry pads, and 
changed whenever they began to dry up. Besides this, the 
child was twice a day put in a bath of 15° Reaumur (65|° 
Fahrenheit), and left in it for five minutes ; these baths were 
continued with a gradually decreasing temperature of the 
water, for twenty days longer, even after I had declared 
the child perfectly cured. 

What is remarkable in this case, is, that the mother, for 
whom I had also ordered the daily bath, had entirely re- 
covered ten days sooner, so that I was not afraid to put the 
child again to her breast on the twelfth day.* 



*The above case of the treatment of the mother, I reserve for my 
work, containing the practice of twenty two years, which will shortly 
be published. 



RUPTURES. 

Those ruptures, to which children are subject, are at the 
navel (hernia umbilicalis), at the groin (hernia inguinalis), 
in the scrotum (hernia scrotalis) and at the thigh (hernia 
cruralis or femoral hernia), with which the child is either 
born, or which it gets by violent crying. Most ruptures 
by which children are troubled, are at the navel, which is 
solely to be attributed to the improper tying of the navel- 
bandage or belly-band by the nurse. Removal of the cau- 
ses of violent screaching, proper diet of the mother, or if 
the child is older, of the child itself, application of a proper 
band or bandage, (in ruptures at the navel, the before-des- 
cribed bandage is of eminent service), every day cold wash- 
ing of the whole body, hip and half baths have given 
in my practice, in from six weeks to fourteen months, at 
latest, the most desirable results. 



RUPTURE AT THE RIGHT GROIN. 

Joseph Muehl, son of an apothecary, ten years of age, 
strong and otherwise healthy, when springing over a ditch, 
fell and was suddenly ruptured. It was a hernia inguinalis- 
scrotalis. After different embrocations had been used for 
eight months, and the patient had worn a troublesome band- 
age or truss, I was consulted. The boy was now washed 
every morning in quite cold water, affusions were made 
132 



RUPTURES. 133 

over the small of the back and the groins, and he had to 
take four hip baths a day, each of fifteen minutes. After 
the rupture had been reduced, a six-fold compress, which 
had been dipped in cold water and wrung out, w T as placed 
over the right enterior abdominal ring, and held by a simple 
pledget of the size and form of a walnut, and fastened 
around the body by means of a simple body-girdle and 
thigh-strap made of English linen. At the same time we 
did not omit to change the compresses, when they got 
warm, for others dipped in cold water. The patient was 
obliged to remain in the open air as long as possible, taking 
moderate exercise, and only food, which was of easy diges- 
tion was allowed. 

In consequence of this treatment, which was exactly 
followed ; the widened exterior abdominal ring, closed so 
completely, that at the expiration of ten weeks, experi- 
ments were made by coughing, blowing, and sneezing, 
without a truss, and the rupture did not appear any more. 
However I told the patient to continue the ablutions, and 
the wearing of the pledget for eight weeks longer, after 
which this was discontinued, and no further sign of a rup- 
ture has ever appeared. 

12 



SMALL-POX. 

This disease, which even in the last quarter of the past cen- 
tury, was much dreaded, and which not unfrequently appeared 
as an epidemic, used to kill as many children as it maimed. 
Every thing was tried to arrest this disease, but even the 
artificial inoculation of the small-pox would not do, until at 
last Dr. Jenner succeeded in discovering vaccination, or the 
inoculation of the cow-pox. But unfortunately, through 
the length of time or insufficient precaution, and neglect of 
the existing rules, the efficacy of this so well tested preser- 
vative, seems to abate somewhat, as in the last ten years we 
have had more cases of small-pox than in any other ten 
years of this century. 

Although, when compared with the times, before the in- 
vention of vaccination, attacks of regular small pox are rare, 
the character of the disease has continued the same to this 
hour, as well in its intensity as in its duration and course. 
Therefore the same fear prevails wherever this malady ap- 
pears, as the power of medicine is very inefficacious against 
its violence. 

Of the numerous cases of small pox, which have occurred 
in my ldng practice, I shall describe two of the most recent. 

Real' small pox is an infectious disease, w T hich spreads 
from one member of a family to another, and even over 
whole districts, not only disfiguring the body by its baneful 
effects, but threatening the lives of children and of grown 
persons. Although, as we have already said before, by the 
introduction of vaccination, the epidemic recurrence of this 
disease has been checked, it cannot be denied, that, particu- 
larly since about ten years, frequent single cases have oc- 
134 



SMALL-POX. 135 

curred, which, the same as before the introduction, have 
terminated by maiming or destroying the patient. 

Of all the remedies that have been used for this disease, 
the safest has been the application of water. Here are the 
two above mentioned cases. 

Mary Sanguinity, from Lecka, on whom the first vacci- 
nation had taken no effect, and w T ho at the second had 
pseudo small-pox (varioloid), had an attack of real small- 
pox in her fourth year, after her father, her mother, and 
another child of the house had been attacked, and the 
mother as well as the child had fallen victims to the dis- 
ease. At a professional visit of the father, who had been 
taken ill nine days before, and of the mother, who was at 
the point of death, and of the other child, I found the 
little girl in the height of fever, squeezed in her little bed, 
almost helpless. 

August 16th. The sick child was very uneasy, tossed 
about the bed ; the skin was dry, burning hot ; from time to 
time spasms in the hands and feet ; the pupil of the eye was 
enlarged, the white of the eye was red, the cheeks red, the 
teeth brownish, the breath hot, and as well as the evapora- 
tion from the skin, accompanied by a peculiar smell ; the 
urine, which was voided but rarely, brownish red. In the 
face, particularly on the upper eyelids, on the breast and 
thighs, appeared small spots of the size of a millet seed, to 
that of a lentil, in the larger ones the projection over the 
skin was distinctly visible, and in the middle a small knot 
could be perceived, the trifling elevation of which could be 
distinctly felt. The breathing of the child at the same time 
was oppressed, and it could swallow only with difficulty. 
I ordered wrapping up in cold sheets, not wrung much, 
which had to be changed as often as they commenced to get 
dry, and cold fomentations around the head and the neck, 



136 SMALL-POX. 

which • were changed as soon as they became warm. As 
food I ordered fresh cow's milk, and for a drink a moderate 
quantity of fresh water from the hydrant or fountain. 

August 18th. After the wrapping up in cold sheets had 
produced several sweats, the little girl was every time 
washed in water of a temperature of 18° Reaumur (72 J° Fah- 
renheit) ; she was then not wrapped up again, until the heat 
of the fever returned, but the application round the head and 
neck were continued. Under these circumstances, the dis- 
ease reached its height, that is, the time of maturation. 
The small-pox covered the whole body either singly or in 
groups, most generally the face and the breast. In the face 
they appeared particularly about the eyes, and so much so, 
that these were entirely closed ; in the whole face there was 
not a spot the size of a nail's head that was free from the 
eruption, and the face itself was swelled. The single 
pustules of the eruptions showed a faintly circumscribed 
areola, in the midst of which was a blueish white pustule of 
the size of a lentil, split in two, which, on opening, dis- 
charged a dirty white, somewhat transparent lymph. Already 
on the 17th of August, the fever had commenced with great 
violence, and seemed to have reached its greatest height in 
the evening, the patient becoming very uneasy, tossing 
about in the bed, frequently talked incoherently, and having 
spasms in her hands and feet, swallowing at the same time 
being very difficult, the cough frequent, and the pulse much 
accelerated, thread like, small and unequal ; the peculiar 
smell of those affected by small-pox had also much in- 
creased. 

In the course of the day, fresh milk from the cow, barley 
water, and pure water to drink were given to the child 
alternately ; cold applications were made round the neck 
and head, which were changed whenever they began to get 



SMALL-POX. 137 

dry. The eyes were frequently washed with luke warm 
milk and water, and over them, a single linen rag, dipped 
in sweet cream was placed, which, as often as it commenced 
to dry up, was exchanged for a fresh one. This kind of 
fomentation was applied on the 19th over the whole face, 
to prevent too strong a suppuration, and with it the marks 
it leaves behind. 

August 21st. The symptoms of the disease described 
under the 18th, had decreased this day, the tenth of the 
disease, and the fifth of the treatment, so far, that the at- 
tacks of fever disappeared entirely ; the child could open 
her eyes, asked to eat, and was able to swallow properly. 
The eruption had already dried up, the scabs came off easily 
by bathing twice a day, for five minutes, in a glutinous 
water of scalded bran of 18° Reaumur (72|° Fahrenheit), 
and later the whole skin scaled off, the baths being con- 
tinued. However, the same evening, a diarrhoea made its 
appearance, which, during the right, became very violent. 
I ordered injections of starch every three or four hours, and 
fomentation of luke-warm water, 16° Reaumur (68° Fah- 
renheit), round the abdomen, and in twenty-four hours the 
diarrhoea was checked. On the 14th day of the treatment 
the child was running about the room perfectly well, and 
later no marks could be perceived in the face. 

Frank Aulich, in Neustadt, ten years of age, of a strong 
and healthy, but bloated appearance, took to his bed on the 
12th May, when the parents perceived an eruption of the 
skin. Not suspecting anything bad, and deprived of all 
means, they left the child without any assistance, until I 
visited a patient in their place, which was at a considerable 
distance from my residence. On this occasion they reques- 
ted me to visit also their sick child. I found the boy in a 
bad condition, there was a rattling noise in his throat, and 

12* 



138 SMALL-POX. 

the whole body was covered in such a manner with the 
small-pox, that not a single feature could be traced in his 
countenance. 

The whole body, and particularly the head and the hands 
were swelled, and as if covered with a crust of marble, the 
eye, by means of hardened pus was closed, the speech and 
hearing were lost, the wings of the nose (alse nasi) in con- 
stant motion, the lips and the tongue dry and cracked or 
chapt, the breath much oppressed, the abdomen swelled and 
painful, no stool, the urine of a brownish color, and like 
the really colliquative (excessive) perspiration, and the sur- 
rounding atmosphere, smelling very badly ; besides the lit- 
tle fellow kept constantly playing with his fingers, and 
murmuring between his teeth, the pulse was small, thread- 
like and oppressed. In order to relieve the miserable ner- 
vous condition, and to check the excessive perspiration, I 
ordered fresh enveloping of the whole body, in well wrung 
cold sheets, as often as they began to dry up ; at the same 
time the boy was placed four times a day into a bath of 
15° Reaumur, (65|° Fahrenheit), consisting of a mixture 
of milk and water, and cold applications of well-water 
were made to his head. Over the eyes, as well as over the 
whole face, fine linen rags, dipped in sweet cream were 
placed, and changed very often, and the other parts of the 
body, as they were so thickly covered with the crust, were 
also smeared with sweet cream. Besides some water given 
frequently, but in small quantities, and some milk, the child 
received inwardly every half hour, a piece of ice the size 
of a pea. 

Already, the second day, the violence of the disease aba- 
ted, the child had a stool, on the third, the nervous charac- 
ter of the disease disappeared, and with it the excessive 
perspiration, after which the enveloping and the ice were 



SMALL-POX. 139 

discontinued. By means of the continuance of the said 
baths, frequent drinking of water, cleaning of the eyes, ap- 
plying sweet cream to the crust, in the face, and on the 
rest of the body, the exfoliation proceeded so rapidly, that 
on the 12th day of the treatment the patient was running 
about quite well, without complaining ; and with the ex- 
ception of some trifling marks, nothing could afterwards 
be perceived of the malady. 

As in the two above related cases, when the treatment 
has been correct, we shall in no type of small-pox have to 
combat bad consequences. 

The same treatment may be applied to other disease's, 
resembling small-pox, observing, that the air of the room 
must be kept constantly pure, and that the patient is to be 
but lightly covered. Further it is necessary, particularly 
when at the same time, and in the same place several cases 
of this kind have occurred, as soon as the child is observed 
to become uneasy, complains of weakness of the limbs, of 
head-ache and sore throat, of difficulty of swallowing, to 
make cold fomentations to the head and throat as described 
above. Cold water should frequently be given to the pa- 
tient to drink, and the diet be confined to milk food ; at 
the same time washing frequently and rapidly in w r ater at 
15° Reaumur (65|° Fahrenheit), and w T hen the fever in- 
creases, wrapping the patient repeatedly in damp cold 
sheets. Only very rarely, and in the highest stage of tor- 
por, where this will not yield to the treatment, described in 
the history of the last case, and the danger reaches the 
greatest height, several pails of cold water should be poured 
over the head of the patient until consciousness returns, 
after w^hich fomentations should be applied to the head and 
neck, and the patient be wrapped in dry sheets. As soon 
as the state of torpor returns, the same proceeding should 



140 ABDOMINAL TYPHUS. 

be repeated, until they disappear entirely, after which the 
treatment is continued as described before, namely, the 
wrapping up in sheets, or the bathing. 

Innumerable cases of this disease have convinced me that 
the treatment with water, is to be preferred to all use of 
medicine, because it not only prevents every subsequent bo- 
dily defect, and no further treatment is afterwards required, 
but to the astonishment of everybody the patient recovers, 
when we are already justified to doubt the possibility of 
preserving his life. As a proof of the healing power of 
water in such diseases, I shall only state that of 180 small- 
pox patients, of which 29 were adults, only five died ; and 
of these five, when I was called in, two were already suf- 
fering from brain-fever, two were suffocating, and the one 
was expiring, after his strength had been exhausted by ex- 
cessive sweating, and suppuration of the eruption. When 
I used to treat the disease otherwise, I used to lose a great 
many, and I therefore was induced to prefer that mode of 
treatment, and to recommend the same to all my friends. 

ABDOMINAL TYPHUS. 



Generally commences with prostration of the limbs, dif- 
ficult breathing, dejection, loss of appetite, disgust, incli- 
nation to vomit and frequently with much increased thirst. 
The head pains, the abdomen, but particularly the navel is 
distended towards the right side, and very sensitive, the 
skin dry, hot, the stool very indolent, the urine colored, 
and sometimes clouded. The fever, in which cold and heat 
alternate, resembles a continued fever. 

Fomentations on the abdomen and the head, wrapping 
the whole body in damp linen sheets, and drinking plenty 



DIARRHOEA. 141 

of wateiywill restore the patient to health in two or three 
days, if the physician is sent for in the beginning of the 
sickness. But if the inflammation has made some progress, 
and the body is reduced by the fever, it will take from six 
to eight days, before the patient feels well again. 

As to the changing of the fomentations, it should be re- 
gulated by the violence of the pain, and the disposition to in- 
flammation, so that it has often to be done every ten to thirty 
minutes. At any rate, care should be taken that the heat 
which forms under the cloths does not become troublesome 
to the patient, which must also be understood of the wet 
sheets, in which he is wrapt, these are to be changed every 
two hours, every hour, and sometimes even more frequently. 
But when we observe that the heat which is formed between 
the skin and the sheet, is not troublesome to the patient, 
and a perspiration is induced, we may leave him in them, 
if the pains in the abdomen have already ceased from half an 
hour to an hour, after which he should be washed rapidly, 
the fomentations be put on the abdomen, and when the 
heat returns he should be again wrapped in a wet sheet. 

DIARRHOEA. 



Diarrhcea may be caused by improper diet of the mother 
or nurse, who suckles the child, by overfeeding or by some 
act of the grown child itself; also by taking cold. In the 
first case, when the diarrhcea is gastric, the patient com- 
plains of headache, inclination to vomit, pressure in the re- 
gion of the stomach, a pinching pain about the navel ; when 
the tongue is foul, or when, with little children, the fore- 
head feels hot, these parts are painful, and pap-like, thin 
stools, with indigested food succeed each other rapidly: 



142 DIARRHCEA. 

give alternately half and whole injections every hour or two, 
make exciting fomentations over the abdomen, which must 
be frequently changed, the same over the head ; to children 
of three years and upwards, give plenty of water to drink, 
until they begin to vomit ; observing in this case as well as 
in the following, a strict diet, giving nothing but a little 
water-gruel, and in the course of a day or two, frequently 
in ten or twelve hours the whole sickness will disappear. 

In diarrhoea arising from cold and rheumatism, the treat- 
ment is exactly the same, because the two forms of disease 
only differ in this : the fever in diarrhoea from cold, is more 
general, more violent, and takes a more inflammable cha- 
racter, whilst the skin is dry, hot to the touch, and more 
disposed to perspire, the stools attended with more urgency, 
and at last consisting of mucus, the pain spreading over the 
whole abdomen. With the rheumatic diarrhoea on the con- 
trary, the fever is not so violent, not of regular duration, is 
often accompanied by chills, and goose-skin, because the 
pores of the skin are spasmodically contracted, the thirst, 
compared with the other two cases, is trifling ; the very 
thin, more watery stools are discharged frequently, during 
a tearing moving pain in the lower part of the abdomen. 
Strict diet, moderate drinking of fresh well or hydrant 
water in small quantities at a time, warming fomentations, 
well wrung, which must be changed as often as they begin 
to get dry, frequent enveloping, which also must be changed 
often, followed by ablutions at 12° to 18 Reaumur (59° to 
72|° Fahrenheit), and half injections of a dissolution of 
starch in a temperature of 10° to 12 Reaumur (54| to 59° 
Fahrenheit), will soon stop both the pain and the diarrhoea, 
without any further consequences. 



SUFFOCATION. 

This affection generally attacks children at the earliest 
age, mostly, soon after they are born, during suckling and 
teething; more rarely in the later periods of life. The 
cause of the frequent fits of suffocation, which often termi- 
nate in actual suffocation and death, in cases which occur 
soon after the child is born, lies in the accumulation of 
mucus in the cavities of the nose, the mouth, and the throat. 
For this reason it is necessary, as we have mentioned before, 
that these cavities should be examined as soon as the child- 
ren come into the world, and be cleaned with a soft rag 
steeped in water and wrapped round the finger. Other 
causes of choking are : constant screaming, convulsions, 
when crying, when sucking, or when eating mush or flum- 
mery, particularly when very hot. Suffocation is also 
brought on by swallowing food too rapidly, which on ac- 
count of its size or condition, cannot pass through the 
throat, and further, in consequence of spasms, hooping- 
cough, and croup. 

A quick removal of the contents of the mouth and 
throat, by cleaning the cavities, vomiting, whilst the head 
of the child is held downwards, and forwards, or pushing 
the contents into the stomach, which can best be done by 
tying a small piece of sponge to a piece of whalebone or a 
quill, together with affusions of several pitchers of water 
over the head, neck and spine, will soon restore the child ; 
the latter are particularly efficacious, as the history of the 
following case will show. 

Minna Poosch, eight months old, very lively, stout, well 

fed, and in good health, was, in the first weeks of teething, 

143 



144 SUFFOCATION. 

attacked by a violent cough, to which, after the third day, 
came spasms, which terminated by a fit of choking. 

Every day, the stout healthy child became thinner, the 
attacks were more violent, and threatened each moment to 
terminate life. 

After every allopathic remedy had been applied in vain, 
and the attending physician had given the child up, I was 
called in by the parents, who were distractedly alarmed for 
the life of their only child. 

As the fever, particularly the heat, which regularly ap- 
peared before the attack, was very violent, the child was 
well wrapped up in a wet, cold sheet, and covered, whilst 
every two hours an injection of a tea-cup of cold water was 
given, and cold water and skimmed cow's milk allowed for 
a drink. When the sheet was dry, or when the heat re- 
turned, the patient was wrapped up anew. When attacks 
of suffocation, with or without convulsive cough or spasms, 
or the reverse, appeared, affusions were applied in the fol- 
lowing manner. The child was put in a large tub, and held 
in it by two persons, one on each side, and rubbed during 
the affusions, whilst a third person supported the head of 
the child, with the left hand, and bent it forwards, so that 
the water could not run into its mouth. The pitcher, con- 
taining about a gallon and a half, was held two feet over 
the head of the child, and poured in a stream over the head, 
neck and back. This was continued until these threatening 
attacks ceased altogether, after which the child was put, 
wet, but wrapped in dry sheets, in its bed. When the heat 
returned, the enveloping was again resorted to, and when 
the other attacks appeared again, the affusions. Already, 
during the first affusions, the spasms, and with them, the 
fits of suffocation, during which the child used to become 
blueish red, the pulse and breath to stop, and the glassy eye 



INFLAMMATORY FEVERS. 145 

to turn in the head, abated considerably. During the 
second, the fits became of shorter duration, so that on the 
fourth day, the child was not only rid of them, but could be 
said to be entirely cured, as it had even cut its teeth, and 
the cough and spasms had disappeared and returned no 
more. 



INFLAMMATORY FEVERS. 

These seldom attack children alone, they are mostly con- 
nected with some local or otherwise acute maladies. The 
purely inflammatory fever generally assails children who 
are stout and strong. 

A child, attacked by such a fever, becomes uneasy, ter- 
rified, its nails are blue, the hands and feet cold, then fol- 
low chills, which seldom last more than half an hour or 
three quarters, the abatement of which is plainly perceptible. 
The eye, which, during the chills, is inanimate, obtains life 
and sparkles, the heat of the head augments evidently, and 
the child asks to drink. At this period, a dry, lasting heat, 
spreads rapidly over the whole body, the skin becomes 
dry, parchment like, and burning hot ; the eyes begin to 
sparkle, the cheeks burn, the tongue becomes dry and chapt, 
the breath is short, whilst the abdominal muscles, which are 
drawn in, are moving, the rest of the body is frequently as 
red as scarlet ; perspiration and stool entirely wanting ; the 
urine is sparing, very red, clear, and smells bad, the pulse 
much accelerated, full and hard. 

This disease, by which children are generally attacked, 
in consequence of having caught cold, disappears for certain, 
under the following treatment, without leaving any bad 
symptoms behind, and as quickly as it commenced. 

13 



146 INFLAMMATORY FEVERS. 

The first problem for the attending physician, in this case, 
is, to diminish as soon as possible the temperature of the 
body, increased by the accelerated circulation of the blood, 
thereby to prevent the consequent effect upon the brain, or 
some other organs, as also the decomposition of the blood. 

The best way to effect this, is to wrap the patient, accord- 
ing to the degree of heat of the body, in a single or double 
sheet, which has been steeped in cold water, and has been 
slightly wrung out, and to change this every quarter of an 
hour, every half hour, or every hour. At the same time 
cold fomentations, covered with dry cloths, are to be made, 
which, according to the degree of determination of the blood 
to the head, must be changed more frequently than the 
sheets. 

In this kind of inflammatory fever, the child should be 
given cold well or hydrant-water as often as possible, but 
only in small quantities. When after three or four envel- 
opments, the heat of the fever does not abate, but con- 
tinues, the tongue becomes dry and chapt, and like the 
teeth and lips assumes a brownish color, give every quarter 
of an hour a piece of ice, the size of a small pea, after which 
the child ought to drink, every time. As long as the skin 
remains hot, dry, and parched, we ought neither to wash 
the child nor drive it into a perspiration, and less so, when 
with, or during the fever, sore throat, and difficulty of swal- 
lowing make their appearance, because when the violence 
of the fever is passed, an eruption generally follows, which, 
by this precipitate proceeding, might easily be driven 
back. 

As soon as we perceive that the child swallows with dif- 
ficulty, we ought not to neglect to put the cloths, folded 
four double, steeped in water, and well wrung, from one 
ear to the other, in front, over the throat, and to keep them 



INFLAMMATORY FEVERS. 147 

firm by means of a dry cloth, changing them as often as 
they become warm. 

When the head of the child becomes more free, the eye 
more cheerful, the tongue moist, the violence of the fever 
has abated ; when the skin, which now is less hot to the 
touch, becomes soft and greasy like, the child may be 
washed in fresh water of from 8° to 10° Reaumur (50° to 
54|° Fahrenheit), but when there is any sore throat, in 
water of from 10° to 15° Reaumur (54 J° to 65|° Fahren- 
heit); after which it ^ to be wrapped wet, in dry sheets, put 
to bed, and covered moderately. We must now await, if 
perhaps a perspiration will follow. If after an hour this has 
not taken place, or if the heat of the body increases again, 
and the skin begins to get dry, we must not delay to renew 
the wrapping up, and if the skin becomes sticky, to leave 
the patient in the sheets until perspiration ensues, in which, 
if the head is free, the child may continue from half an hour 
to a whole hour, and be washed afterwards in water of 12° 
to 15° Reaumur (59° to 65|° Fahrenheit). 

When, after this treatment, all the former symptoms 
which have been described as dangerous, that is, violent 
headache, difficulty of swallowing, dry,chapt tongue, diffi- 
cult breathing, and the fever heat, have disappeared, let the 
child be washed in fresh water of 8° Reaumur (50° Fah- 
renheit), let its diet be confined to fresh skimmed cow's 
milk, and let it be carried about the room, or if it is strong 
enough, let it walk about. But if there are symptoms of a 
coming eruption, the child should remain in bed, at a mode- 
rate temperature, the fomentations on the head and neck 
being continued, and it should be washed with water of 
from 15° to 18° Reaumur (651° to 72|° Fahrenheit), three 
or four times a day. 

If, as has been mentioned before, there is no local affec- 



148 INFLAMMATORY FEVERS. 

tion connected with it, the fever, under such treatment, will 
pass off in two or three days, and the transit from sickness 
to health will be as rapid. Should it however be connected 
with some local complaint, we must then modify the treat- 
ment according to the form of this complaint. 

HISTORY OF A PURELY INFLAMMATORY FEVER IN THE 
HIGHEST STAGE. 

August 24. In the afternoon I was called to see a boy, 
four years old ; I found the child in the lap of the mother, 
who was much frightened, tossing about, with a really 
burning fever, which even communicated itself to the mother. 
The head was much affected, the white of the eye blood- 
shot, the face puffed up, and very red, tongue, dry, foul, 
brown, and like the lips, chapt. The little fellow tossed 
about anxiously, and on account of the dryness of the tongue, 
could not articulate a single intelligible sound ; the respira- 
tion made a rattling noise, and was performed by the aid of 
the abdominal muscles, the skin, which was very red, and 
in some parts had a yellowish cast, was as dry as parch- 
ment, and burning hot, the pulse quickened, full, tense and 
hard ; no stool for the last forty-eight hours, and the scan- 
tily discharged urine showed itself of a brownish color. 

The child was wrapped in double linen sheets, moderately 
wrung, from the head down, over the feet, which in the begin- 
ning were changed every twenty minutes, later, accordingly 
as the fever abated, every half hour, every hour, and finally 
every two hours ; at the same time applications of finely 
pounded ice were made over the head, and a bit of ice, of 
the size of a swelled pea, given to the patient in a spoonful 
of fresh water. After this treatment had been continued for 
twenty-four hours, the boy could speak aloud, swallow 



INFLAMMATORY FEVERS. 149 

properly, and the fever, and with it the heat, had diminished 
so much, that he could be declared out of all danger. 

On the 25th, at eight o'clock in the morning, the boy- 
having slept the greater part of the night, although he had 
been wrapped up several times, and his skin having become 
moist, I ordered him to be wrapped up in a single, well 
wrung, damp linen sheet, to induce perspiration, which 
broke out after an hour and a quarter, and continued copi- 
ous, whilst cold water was frequently given, for half an 
hour. After this I had the child put in a tub, and washed 
quickly, in water of 10° Reaumur (54| Q Fahrenheit), 
after which, without being dried, he was wrapped in a dry 
linen sheet, and put into bed. After a little while a cup of 
skimmed milk was given to him, which, besides a little 
wheaten bread, formed his food for the next three days. 
As the heat again increased towards noon, I ordered the 
single enveloping to be continued, to make only fomenta- 
tions of cold water, and to give the patient plenty of cold 
water, without ice, to drink. After the fever had entirely 
disappeared, about eleven o'clock, the child was well washed 
in water of 8°,Reaumur (50° Fahrenheit), and finally three 
gallons poured over him, after which he slept very quietly 
until morning, awoke quite well, and after he had been 
washed again, ran about the room as lively as possible. 

The above mentioned ablutions w T ere repeated the same 
day, the third of the treatment, every four hours, and the 
patient, after each, put to bed for a short time. His diet 
now consisted of a little soup, and some apple-sauce. 

The next morning, to the great joy of the parents, who 
had already given up all hope of his recovery, as the dis- 
ease, in spite of all the remedies had become worse and 
worse, until water was applied, the boy was perfectly well, 
and on the same day, the fourth of the treatment, was taken 

13* 



150 INTERMITTENT FEVERS. 

into the fresh air. This was found very useful, and, as 
from that time, he was every morning washed over the 
whole body with cold water, and cold water thrown over 
him, he remained in good health. 

INTERMITTENT FEVER, OR FEVER AND AGUE. 

Intermittent fever is a disease, w^hich frequently appears 
as an epidemic, visits certain localities every year more or 
less, and according to my observation and that of others, 
never attacks infants, # but often children of a more ad- 
vanced age. 

The cause is mostly to be found in gastric matter, which 
remains in the first ways of digestion. Children w T ith a 
bloated look, with high bellies, are most subject to attacks 
of this disease. This kind of fever, when it occurs as purely 
intermittent, cannot be mistaken. The attacks, the parox- 
isms, the physical weakness, then cold, shivering, heat and 
perspiration following in a regular order of succession, and 
recurring at certain periods ; leaving the patient between 
the paroxisms generally well and with a good appetite, are 
the sure symptoms. These fevers are divided according to 
the length of the intervals between the paroxisms: a, into 
quotidian, when the w T hole paroxisms, together with the 
interval, occupies only twenty-four hours ; h, into tertian, 
when the paroxisms comes on every other day, the interval 
occupying one whole day ; c into quartan, when the parox- 
ism appears every third day, leaving an interval of two days 
free of fever, and so on for those of five, six, seven and 
eight days. 



* Although many physicians are of opinion that the child is subject 
to intermittent fever at every period of life. 



INTERMITTENT FEVERS. 151 

Besides these, however, there are several other kinds of 
intermittent fevers, namely the complicated ones, where two 
paroxisms appear the same day, and which, according to 
the periods when they appear, are divided into double, tri- 
ple, quadruple and manifold. # To these must be added the 
masked ones, which are so called, because, with the inter- 
mittent type, another disease is connected, on account of 
which, it becomes difficult to distinguish the former, and it 
therefore happens frequently, that the character of the fever, 
namely, that of intermittent, remains unnoticed, whilst the 
form of the disease alone is attended to. 

In the same manner, as the fever may be overlooked, so 
on the other hand the disease may be overlooked or mista- 
ken, when the character of the fever bears some resemblance 
to that of intermittent, which occurs most easily with chil- 
dren at the time of teething, particularly when cutting their 
wisdom teeth. 

The phenomena, attendant on an intermittent fever, and 
by the peculiarity of which it makes itself known, vary 
very much. With children in particular they often present 
a very confused picture. We can however convince our- 
selves of the existence of this kind of fevers by their return 
on certain days, and even at certain hours with prostration 
of the limbs, chills, (under the influence of which, the 
finger-nails and toe-nails first become blue, the hands and 
feet turn quite cold, and after which, shivering and often 



* As here is not the place nor sufficient room to enter largely into the 
special character of the disease, I take the liberty to refer to a work, 
which will shortly be published by me, under the title of: " Botanical 
Practice," and in which I shall enumerate all the diseases, which can 
be cured by means of herbs and roots, and explain both their correct 
diagnosis and their botanical treatment. 



152 INTERMITTENT FEVERS. 

chattering of the teeth, follow) ; after this, heat, termina- 
ting in perspiration. 

A regular diet is most necessary. If the child is still 
sucking, the mother must live upon spare food without any 
spices, and strictly avoid all exciting spirituous drinks. If 
the child is w T eaned, and already several years old, we 
should, if not some other disease exists at the same time, 
look to it, that it receives sufficient food, but avoids all 
meat and greasy victuals, spices and spirituous drinks, and 
that it takes nothing to eat, two hours before, and two hours 
after the paroxisms. 

During the intervals of the fever, frequent exercise in the 
open air, and in the morning and evening, cold ablutions, 
followed by affusions are essential. In intermittent fevers, 
accompanied by headache in front, inclination to vomit, 
want of appetite, pressure in the region of the stomach, 
costiveness, I can recommend frequent drinking of cold 
water, injections of the same 10° to 12° Reaumur, (54|° 
to 59° Fahrenheit), cold wet fomentations around the abdo- 
men, and if this does not produce the desired evacuation, hip 
and half-baths in water 8° to 10° Reaumur, (50° to 54|° 
Fahrenheit), under constant friction of the abdomen and of 
the feet. As soon as the first symptoms of the paroxisms 
make their appearance, the little patient should be en- 
veloped in a cold wet sheet, well wrung, to induce perspi- 
ration by the vapor, w T hich is generated between the sheet 
and the body. This will abate the chills and terminate 
them the sooner, as they are particularly dangerous for de- 
licate children, producing a violent shock upon the nervous 
system, besides this the shivering is frequently accompanied 
by spasms, which may endanger the life of the child. 

If the cold passes off, and the heat appears, without per- 
spiration or symptoms of perspiration, if the skin becomes 



NERVOUS FEVER. 153 

dry, and the heat increases, we should not hesitate to renew 
the enveloping, which this time, however, must be more 
damp, wringing the sheet more or less according to the 
degree of heat. This treatment must be repeated until the 
perspiration appears, as often as the sheet becomes dry. At 
the same time we should give the patient to drink, when- 
ever he asks for some, and not neglect to make cold fomen- 
tations over the forehead and the top of the head. 

When by this treatment, which may be modified in dif- 
ferent ways, perspiration makes its appearance, the child 
must be left in it, until the whole body is covered with it. 
When this is accomplished, a fresh drink should be given, it 
should be taken out of its bed, and placed in an empty tub ; 
here it should be well washed with a sponge, from two to 
five minutes, with water of 10° to 18° Reaumur (54J° to 
72J° Fahrenheit), the water poured over it, and after it 
has been thoroughly rubbed and dried, it should be dressed 
and brought into the fresh air, where it should take as 
much exercise as possible. 



NERVOUS FEVER. 

Nervous fever is a disease, the name of which alone creates 
terror, not only in single families, but over whole districts, 
where such a case occurs. It is a disease, which spares no 
age, and which has decimated whole districts, but in which 
cold water, for a long time past, has proved not only the best 
curative, but also the safest preventive remedy,* which Dr. 

* Already in earlier times, physicians have recommended the cold 
water for nervous fevers, among others, Coldani, at Naples, in 1724; 
Lorry, in Egypt, William Wright, in Edinburgh, 1779 ; Janus Charru, 



154 NERVOUS FEVER. 

Hollmann in Berlin has clearly and incontrovertibly demon- 
strated in his late excellent work, " The Typhus of 1844." 

The nervous fever appears under different characters, 
sometimes it begins with a state of excitement in the ner- 
vous system, at other times with a diminished nervous vita- 
lity, with a disposition to lameness ; sometimes as a pure 
nervous affection, and again as a symptomatic affection in 
the form of so called bilious, gastric, mucous nervous fevers. 
So also with predominating suffering of the brain, of the 
spinal marrow, or the ganglia of the abdomen, in which case 
it is called abdominal typhus. 

But however numerous this species of nervous fevers may 
be, it is not difficult to know them, for in this mode of 
treatment, we have not so much to do with the peculiar 
type and form of the disease, as rather with the disease itself, 
and the best manner of assisting the efforts of nature. 

By nervous fevers in general, we understand such, as 
without any sentient perception, exercise a peculiar influ- 
ence upon the nervous system, in such a manner, that an 
irregularity in the same system shows itself, which threatens 
life ; they are in no relation with the causes whatever, and 
the symptoms go off without order, and do not connect with 
the intensity of the fever ; finally they either appear under a 
peculiar state of excitement, or a peculiar prostration of the 
nervous system. 

The nervous fever is generally preceded by certain pre- 
cursory symptoms, consisting of a chilliness and subsequent 
heat. The child complains of more or less dullness of the 
head, the appetite disappears, the tongue becomes white, the 



in Liverpool, 1787; Girard, 1796; Currie and Brandis, Joseph Frank, in 
the Vienna Hospital, 1804 ; Hirsch, in Goldkronach, 1806-7 ; Kolbany, in 
Pressburgh, 1808; Froehlich, m Vienna, 1810; and in more recent times 
Hufeland and others. 



NERVOUS FEVER. 155 

countenance changes color frequently, thirst and sometimes 
vomiting are among the symptoms. The child begins to 
totter in its walk, it can no longer stand, the eye is either 
languid, or piercing, glassy ; giddiness, inclination to sleep, 
sleeplessness, staggering, raving, twitchings of the muscles. 
The patient is often uneasy, tosses about wildly or lies still, 
brooding for himself, his thirst becomes violent, the skin is 
dry and hot, the tongue and lips dry and chapt, and the 
teeth soon begin to be covered with a brownish crust. 
Mostly there is a want of perspiration, and when it exists, 
it is either quite cold, confined to the forehead and face, or 
accompanied by coldness of the extremities. The abdomen 
expands, often appears as if divided by a string in two parts ; 
frequently there is costiveness, and in other cases again, 
loose diarrhoea ; in the state of excitement, the urine is red- 
dish, under all other circumstances, it is red. 

As to the treatment, it differs in so far, that where there 
is increased irritability, we must diminish the warmth by 
local fomentations, general enveloping, and diversion by half, 
full, foot and hip-baths. Where on the contrary, there is 
physical prostration, we must induce perspiration, by wrap- 
ping the patient in wet sheets, after affusions have been ap- 
plied. In case any local symptoms should appear, we must 
give bits of ice, order frequent drinking of fresh water and 
cold injections/* 

Joseph Klein, son of a cabinet-maker, three years of age, 
of delicate appearance, fair, sensitive, had suffered for more 
than a fortnight, from a swelling of the maxillary glands, 



* Reserving all further explanation of the nervous fever and its treat- 
ment, for the publication of my u Botanical Practice," I here add, as in 
all preceding and subsequent cases, for the easier recognition and healing 
of the disease, the most remarkable cases which have occurred in my 
practice 



If56 NERVOUS FEVER. 

with which a fever was connected, which the physician who 
had prescribed before me, had tried to relieve by embroca- 
tions and salts, without, observing that the disease was ta- 
king a nervous character, of which the above mentioned 
glandular affection was not the cause. As the malady in- 
creased, without yielding to the cooling and diverting re- 
medies, I was consulted. 

On the 15th day of the disease, and the sixth of the 
violence, I found the boy in a very violent paroxism of 
fever, the symptoms were inflammatory, the face was very 
red, the tongue furred, a dirty brown, the lips dry and chapt, 
the thirst much increased, the speech faltering, the breathing 
difficult and hot, the sleep interrupted by sudden starts, and 
whilst awake violent disquietude and tossing about ; the 
lower part of the abdomen was distended, burning hot to the 
touch, and painful, the skin dry, and the whole body burn- 
ing like a coal, which, during the twenty-four hours, yielded 
two or three times to a coldness in the extremities, and to 
a cold perspiration ; the patient had from five to six stools a 
day, of the nature of a mucous diarrhoea, whilst the urine 
appeared a bright yellow and clear, and the pulse was much 
accellerated, small, and thread like. All these phenomena 
increased towards the evening. I recognized the disease as 
a nervous fever, accompanied by a heightened state of irri- 
tability, wherefore I prescribed as follows. 

To put round the abdomen four doubled thin cloths, 
which had been steeped in cold water, and to w T rap him in 
equally wet double sheets from head to foot, to repeat the 
enveloping as often as the sheets grew hot ; and to put on 
the head a pig's bladder, half filled with pounded ice. To 
give to the boy every quarter of an hour a bit of ice of the 
size of a swelled pea, in a table spoonful of cold hydrant 
water, without any thing to eat. 



NERVOUS FEVER. 157 

Between the 20th and 21st August, the disease seemed 
to have reached its height, the violence of the fever having 
abated on the 21st. On the 22d, the fourth day of the 
treatment, until which time the above prescriptions had been 
strictly followed, the boy, after a quiet sleep of three hours, 
awoke perfectly conscious, the speech became distinct, he 
was quiet, the tongue was moist and red, the thirst mode- 
rate, the skin moist and disposed to perspiration. 

As this state justified my concluding, that the fever had 
passed its height, that the skin, which had been exhausted 
by the former fever heat, was now strengthened, and that 
consequently the disease might be brought to a desirable 
end, by a salutary perspiration. I ordered the patient to be 
put into an empty tub, as soon as the fever commenced, 
and to be well rubbed with a linen sheet, large enough to 
cover his body, which had been dipped in cold water, and 
had been wrung well, and then to be brought to bed. 
After this, he was immediately to be wrapped in a wet sheet, 
have fomentations applied to the abdomen, and to be well 
covered ; after he had become warm, cold water was to be 
given to him in small quantities. After an hour and 
a half, during which time, I let the child sleep, a salutary 
perspiration made its appearance, which, for the first day, I 
allowed to operate, one hour, for the second, an hour and a 
half, and for the third, two hours; after which we put the 
little patient into a bathing tub, in which he was every time 
well washed, rubbed both wet and dry, and in such a man- 
ner, that the first time the bath consisted of water of 15° 
Reaumur (65|° Fahrenheit), the second of 12 p Reaumur 
(59° Fahrenheit), and the third of 8° Reaumur (50° Fah- 
renheit). 

After this curative process, the disease yielded so rapidly, 

14 



158 NERVOUS FEVER. 

that on the 26th August, the eighth day of the treatment, 
it had entirely disappeared, the appetite returned, and all 
the bodily functions were performed regularly. 

Nothing but a trifling bodily weakness remained behind, 
which in four days, with a regular diet consisting of milk 
and cold meats, and with rubbing twice a day with wet 
linen cloths, was so entirely overcome, that the child ran 
about the house, as well as ever, on the 1st September. 

Lais Pepper, Lutz, thirty years of age, of strong consti- 
tution, having for some time complained of a violent cold, 
was on the 29th December, 1850, attacked by a shivering, 
followed by heat, without perspiration. After the fever had 
lasted for six days, and all the remedies, which had been ap- 
plied had proved useless, I was called in. 

I found the patient in bed, in a weak, unconscious state, 
his eyes looked fixed and glassy, the head heavy, the tongue 
dry and hard, the lips dry and chapt, the teeth covered 
with a brown crust, the breath hot and short, and frequently 
interrupted by dry cough, the face haggard, perspiration, 
none, sleep since five days, none, stools from six to eight 
every day, looking black and thin; urine, very seldom and 
bright yellow ; the lower part of the abdomen somewhat 
distended, burning hot to the touch, the skin dry, and the 
whole body like fire, with a rattling in the throat, whilst 
the patient kept constantly playing with his fingers upon 
the counterpane. 

I recognized the disease as a nervous fever, with increased 
irritability (febris nervosa inflammatoria erethistica), where- 
fore I proceeded as follows : 

Perceiving the danger, I did not even take time to ask 
for the cause, but ordered a big tub to be brought, had it 
filled with cold well-water, and soaked dry linen cloths in 
the water so as to be in readiness. 



NERVOUS FEVER. 159 

I immediately caused the patient to be undressed, and to 
be put in the tub, and had five to six gallons of cold hydrant 
water poured over his head, until sensation became evident, 
after this the patient was well rubbed with a slightly wrung 
sheet, by two persons, and immediately wrapped from head 
to foot in four-fold wet linen sheets, which were changed 
every time they began to get hot ; on the head I ordered 
pounded ice to be placed in a bladder, as also fomentations 
round the neck, and to cover the patient with a blanket. 
After the third envelopment, which took place every ten 
minutes, the patient fell into a soft sleep, the breath became 
purer, and the rattling ceased, and with repeated coughs, 
the patient brought up a tough mucus. On the eighth 
enveloping I was able to give him a bit of ice in a table- 
spoonful of w T ater ; this proceeding had to be repeated in 
the beginning every five minutes, afterwards every ten 
minutes. Two hours after having commenced my treat- 
ment, the patient became sufficiently conscious, so that I could 
ask him, whether he would have something to drink, and 
as much cold water was given him as he wanted. Since 
twenty-four hours he had refused to take anything, and had 
not eaten for six days. This treatment was continued for 
about five hours, but as, in spite of the returned reaction 
of the skin, which now seemed disposed to perspire, the 
general torpor would not give way, I caused the patient to 
perspire in the wet sheet, whilst applications of ice were 
made to the head ; and as soon as the perspiration broke 
out, desired him to remain in it for half an hour, when a 
little thin broth was given. As the heat began to increase 
I ordered him to be washed in cold water, and to have the 
cold enveloping continued. Twelve hours after the com- 
mencement of my treatment, I let the patient again get 
into a perspiration, when I allowed him to continue in it a 



160 HIP-DISEASE. 

whole hour, then, had him washed, put into another bed, 
and wrapped in a dry sheet. The application of ice was 
now changed for cold fomentations around the head and 
neck. The patient was perfectly conscious and took seve- 
ral cups of broth. The wrapping was changed, only every 
three to four hours, which was continued until the third day 
of my first treatment, January 6th, 1851 ; when all symp- 
toms of sickness had disappeared, only cold ablutions and 
cold fomentations on the head, were applied, which were 
continued for a while after perfect recovery. 

I thought it right to give here a short sketch of this case, 
as it occurred but very lately, and as a similar case might 
not present itself so soon, for there must be physicians, who 
doubt the efficacy of a natural treatment, and who would 
be glad to become convinced of the contrary, which in this 
case would be very easy, as there were ten or twelve eye- 
witnesses to the successful termination. 

HIP-DISEASE. 



This complaint is frequently overlooked in the first pe- 
riod of its duration, and thus becomes one of the causes by 
which many children are crippled ; it forms three stages. 

Either from inherited causes, such as rickets, (rachitis), 
scrofula, gout, mercurial diseases etc., or from a blow, push 
or fall, an inflammation in one or the other of the upper- 
articulations of the thigh bone, terminating rapidly or slow- 
ly, forms the beginning of the disease, and the first period 
of this so much dreaded complaint, commences in the fol- 
lowing manner. 



HIP-DISEASE. 161 



FIRST STAGE, OR THAT OF INFLAMMATION. 

Iii the beginning of the disease, there is, in the upper part 
of the thigh, a feeling of numbness, which is soon followed 
by a feeling of fatigue in the morning, and subsequent stiff- 
ness of the same leg, but which disappears later during the 
day. The patient now begins to complain of pains in the 
same hip-joint, which continues to increase, and generally 
are worse in the evening, move about in the thigh, and take 
a rheumatic character, to which fever soon accedes. These 
symptoms may continue, when the course of the disease is 
slow, for months, even years, without any morbid change 
in the hip-joint, perceptible to the eye or to the touch, it 
alternates generally from better to worse, whilst the foot is 
turned out a little, and the walk is dragging. Frequently, 
however, when the inflammation is rapid, the pains become 
violent, a perceptible swelling behind the great trochanter 
(the process of the thigh bone) makes its appearance, and 
the moving of the leg becomes impossible. 

Washing the whole body twice a day, and the whole leg 
four times a day, in cold hydrant water for three or five 
minutes each time, cold fomentations round the whole hip- 
joint, to be changed as often as they begin to get warm, a 
strict, well regulated diet, and rest of the body, will in 
most cases, cure the local complaint. 

When this local inflammation has been entirely overcome, 
we should proceed by a general treatment of the existing 
original cause, which, when the physician finds the disease 
already in the second or third stage, must be applied at the 
same time with the local treatment. But, in case the in- 
flammation should be so violent, that it will not yield to the 
above described treatment, then, pounded ice in an ox- 

14* 



162 HIP-DISEASE. 

bladder should be placed over the suffering part, and be re- 
newed as soon as it is melted. When there exists at the 
same time some continuous inflammatory complaint, the pa- 
tient should be wrapped from two to six times every twen- 
ty-fours hours in a wet sheet, and be washed every time, 
until the inflammation ceases. 

THE SECOND STAGE, OR THAT OF EXUDATION. 

When through neglect, or improper treatment, the in- 
flammation has advanced and already changed to exudation, 
there is formed in the socket of the joint a salty mass, which 
relaxes the round ligament by which the thigh-bone hangs 
in the socket, pushes out the head of the bone, and in this 
manner effects a prolongation of the diseased extremity. 
Thus the second stage has commenced. Now the affected 
side appears somewhat flatter than the sound one, the crease 
is deeper, the muscular part of the thigh becomes gradu- 
ally more flaccid, the whole leg grows thin, and the great 
trochanter turns more outwards and downwards. At every 
motion, by which the head of the bone is pressed against 
the socket, the pain becomes more violent, so much so, that 
the patient often exclaims that he cannot bear it ; the walk 
becomes more and more limping, the whole weight of the 
body rests upon the sound leg, which appears stretched out, 
w^hile the affected limb is bent at the knee, and appears 
lengthened in the thigh, whereby it is brought nearer to the 
sound limb, and the foot generally is turned further out. 
The above described pains begin to diminish, and are worse 
only when there is pressure against the socket, but as the 
second stage advances, they also attack the knee of the 
same leg, so that this pain becomes much more violent du- 



HIP-DISEASE. 163 

ring the night, than that of the hip-joint, and often prevents 
the patient from walking. 

In this case also a radical cure, although it may be de- 
layed somewhat longer, than when treated in the first stage, 
is certain, if we apply the water properly. Here it must be 
effected by an increased power of reaction, by which an 
absorption of what has already exuded is caused. The pa- 
tient must be treated according to the following rules, modi- 
fied by his constitution and temperament. 

With a sluggish temperament, and when the swelling 
j feels doughy, the patient must sweat in dry linen sheets and 
1 a blanket, but with a lively, quick, irritable temperament, 
in damp sheets and a blanket, once or twice a day, each 
time, from one to three hours, according to the strength of 
the patient and the progress, the disease has made, after 
which he is to take a cold bath, from two to five minutes, 
agreeable to the necessity of increasing the power of reac- 
tion, and to the time the perspiration has lasted. 

After this, affusions of from one to three gallons of water 
are made over the hip-joint, that is to say over every part 
of the hip in streaks, and day and night ice is worn over 
the whole surface of the joint. After the affusions, mo- 
derate exercise in the open air should be taken. 

THIRD STAGE. 

In the third and highest stage, the complaint terminates 
by suppuration, caries of the head of the bone, suppuration 
of the surrounding parts, wasting of the leg, or general 
wasting away, and its consequence, death ; or if the child 
be saved, it remains a cripple. 

The third stage has commenced when the limb becomes 
shorter, which happens in consequence of the already ef- 



164 MILIARY FEVER. 

fected destruction of the head of the thigh-bone. This 
has retreated into the socket, which for the same reason has 
become larger, or it is thrust out of it. But in most cases; 
there arises around the whole hip-joint a swelling, whielu 
begins behind the large trochanter, opens in one or morei 
places at once, voids a quantity of bad pus, which becomes 
thinner and more unhealthy, frequently carries away with 
it bony matter or small pieces of bone, forming fistulous 
passages, which heal badly ; emaciation with clammy perspi- 
ration and fever in the morning appear, and the leg wastes : 
evidently away, or swells cedematously (watery) while the \ 
pains decrease. 

The treatment in the third stage is like that of the se- 
cond, only that when already a hectic fever exists, the pa- 
tient should be wrapped in wet, instead of dry linen sheets ; 
he should never sweat, but the skin only become moist ; the I 
half baths are only to be applied as far as over the hip, from; 
two to five minutes, whilst the rest of the body is thorough- 
ly rubbed with a w r et linen cloth. The existing wounds i 
should then be syringed with cold water. 

Several cases of successfully treated disease of the hip, 
would furnish me sufficient matter, to introduce here the his- 
tory of some cases of this complaint, but as I have already 
expressed myself fully on the manner of treatment, I shall 
omit them, in order to gain room. 



MILIARY FEVER. 

This disease is a contagious, eruptive fever, in the course 
of which rounded vesicles of the size of millet-seeds are 
formed, which frequently, not only cover the whole body, 
but also spread over the mucous membrane of the respira- 



MILIARY FEVER. 165 

, tory organs, the salivary glands, and of the alimentary ca- 
nal ; it is characterized by a continued copious sweat. 

This eruption is innoxious, with moderate diet and in a 
mild temperature it passes off regularly, and after three or 
four days dries up, unless it should disappear by itself, in 

1 which case, if this takes place in consequence of a cold or 
improper diet, the miliary fever is apt to fall upon the brain 

. or other important organs, and thus endanger life. This 

m fever, however, seems to remain for a while, in the same 

! locality and even to return to it. 

Although the Miliaria frequently appears as an epidemic, 
I have found, notwithstanding, that in some places it is at 
all times, and that in certain localities, it appears every 
year sporadic (from occasional causes), and not unfrequently 

, becomes endemic. Miliaria, in consequence of its different 

[ forms is divided into several subdivisions. Thus we distin- 
guish the crystal, the white, the red, the purulent, the len- 
til-shaped miliaria, it is also divided into innoxious, malig- 
nant, febrile, critical, chronic, etc. 

These divisions, however, as well as their peculiar form, 
have as little to do with the treatment as the distinction of 
epidemic and endemic. This, with the exception of any 
accessory local complaint, can only differ by the more or 
less violent symptoms, the existing process of inflammation 
etc., as is the case in all eruptive diseases. 

The principal thing in the treatment of miliaria, of every 
kind, is to keep a watchful eye upon the diet of the patient, 
and the temperature in which he lives. The former should 
consist of some milk porridge, or some light boiled fruit, 
best, apples, and for a drink, fresh w T ater, which, however, 
should not be taken in too large quantities, and too often. 
As to the temperature of the sick chamber, it should in 
this, as well as in all other acute eruptive complaints never 



] 66 MILIARY FEVER. 

be above 16° Reaumur (68° Fahrenheit), and never belcrq 
14° Reaumur (63 J° Fahrenheit), in which the patien 
should only be covered moderately. 

In the many hundred cases of inflammatory, cutaneous 
eruptions with sick children, which I have treated, if cole 
or other causes had not driven in the disease, or forced il 
on some other organ, I have invariably found, that mild ab- 
lutions twice a day in water of from 15° to 18° Reaumui 
(65|° to 72|° Fahrenheit), were sufficient. When there 
is great heat, dry skin, and raving, enveloping the whole 
body once or several times in damp sheets will produce a 
salutary sweat, the eruption of the disease, and the removal 
of all threatening symptoms. At the time of desiccation, 
baths of four or five minutes in a temperature of 18° to 
20° Reaumur (72±° to 77° Fahrenheit), suffice to restore 
the child in six or eight days completely. 

If miliary fever appears in consequence of other diseases, 
or if it is accompanied with derangement of the digestive 
organs, the treatment should be modified according to the 
original causes, by some addition, such as plentiful drinking 
of water, cold fomentations and injections. The same is 
the case with that kind of miliary fever, which appears in 
the course of a gastric, nervous or putrid fever. A peculiar 
kind of miliaria we have now in the fever, which appears 
in the beginning of the hydropathic treatment, or after cold 
enveloping and fomentations, which forms no essential phe- 
nomenon, and is not worthy of notice, as it disappears under 
the same circumstances under which it appears. It is dif- 
ferent however with that miliary fever, which appears, after 
frequent sweating, in this case the sweating should be dis- 
continued. 

Susan de Castolitz, daughter of a major, twelve years 
of age, a very handsome girl, fair haired, with blue eyes, 



MILIARY FEVER. 167 

eery delicate, of a mild character, was confined to her bed 
hi the 9th of March, after having complained for a couple 
)f days of weakness of the limbs, headache, and some dif- 
ficulty in swallowing. 

I found the little patient, at ten o'clock, on the same day, 
n a paroxism of fever, which was very considerable. She 
talked incoherently, complained of headache, inclination to 
vomit, pressure in the region of the stomach, and difficulty 
of swallowing. The thirst was great, the skin burning hot, 
and dry, stool for the last two days none, the urine reddish 
and clear. Taking these symptoms at any rate for the pre- 
cursors of some cutaneous eruption, I should have thought 
that the child was breeding scarlet fever, if I had not 
known that miliary fever prevailed, at the same time, in 
several houses of the place. I therefore ordered the little 
girl to be washed in water of 15° Reaumur (65|° Fahren- 
heit), over the whole body, to be wrapped in a linen sheet, 
which had been dipped in hydrant water, and been well 
wrung, to have cold fomentations put round her head and 
neck, and these, as well as the sheets, to be changed as 
often as they became warm. Already when wrapped up 
for the third time, six hours after the commencement, a lit- 
tle eruptive efflorescence appeared. In the evening towards 
seven o'clock, during the third enveloping, the child fell 
Into a perspiration, which, in the course of three quarters 
of an hour, spread uniformly over the whole body. I left 
her in the perspiration for about two hours, until near nine 
o'clock, P. M., and ordered, during this time, the drinking 
of much cold hydrant water, and the changing of the fo- 
mentation of head and neck. After this the patient was 
taken out of bed, dripping with perspiration, and as the 
whole body, particularly the breast appeared scarlet red, she 
was put into an empty tub, was well rubbed with a linen 



168 MILIARY FEVER. 

cloth which had been dipped in water of 15° Reaumur 
(65|° Fahrenheit), wrapped wet in a dry sheet, put into 
bed and well covered, after which she fell into a profound 
sleep. 

Towards one o'clock the eruption had appeared over the 
whole body, and as the heat increased again at one o'clock 
A. M., I had her taken out and washed quickly, after which 
we proceeded as before. 

The day after, that is the 10th of March, as also the 
11th and 12th, the ablutions were repeated every six or 
eight hours, but, as the headache, sore throat, and difficulty 
of swallowing had disappeared entirely, I ordered the fo- 
mentations round the head and neck to be omitted. 

On the 13th, 14th, and 15th March, to promote the ex- 
foliation, full baths of 16° Reaumur (58° Fahrenheit), 
were ordered once a day, at eleven o'clock A. M. They 
were to last two minutes, whilst the extremities were con- 
stantly being rubbed, after which the sick child was again 
enveloped wet in a dry sheet and put to bed. 

On the 16th, the patient was allowed to walk about the 
room, and on the 18th, she was declared perfectly well, 
and although the atmosphere was raw, taken into the fresh 
air, which agreed with her perfectly well, no subsequent 
symptoms of the disease making their appearance. Not- 
withstanding the sudden commencement of the disease, and 
the violence of the fever, the eruption, until entire exfolia- 
tion, lasted only a week, was connected with no danger, 
and the transition from sickness to health was so sudden, 
that no period of convalescence was perceptible. 



TETTER. 

This disease consists of a series of eruptions, including 
a number of species or varieties, which are known under 
the name of Tetter. We shall divide them into six classes. 

1. The scab-tetter, which mostly appears in the face, 
on the breast, upper and lower limbs, particularly on the 
elbow, first forms a red spot, upon which small vesicles 
collect in groups, soon flowing together, exuding a white 
yellowish fluid, then drying up, and forming a chapt, dirty 
scab, under which, a fluid, similar to the one before men- 
tioned, collects again. Children are particularly subject to 
this kind of Tetter. 

2. Dirty-spotted tetter, a variety of the last described ; 
in the beginning, a dirty spot appears on the skin, on which 
there arise single vesicles, which open and form a scab of a 
dirty grayish white, the first layer of which comes off in 
scales, whilst the skin underneath looks sore. 

3. The bran or flour-tetter forms innumerable small pointed 
vesicles on the surface, which open with an itching and 
biting, then dry up, and leave the skin in a condition as if 
it had been strewed with coarse flour or bran ; when these 
scales are wiped away, the skin appears red, uneven, and 
sensitive, but immediately the scales reappear. 

4. The fish-scale tetter resembles that, described under 
No. 3, only with this difference, that the scales of this is 
larger, and lie in two or three layers, one on top of the 
other, and that they itch much more than the flour-tetter. 

5. Purulent-tetter, also a variety of the scab or common 
tetter, of a red color, and surrounded by a violet or red 
areola. The elevated vesicles burst in a short time, and 

15 169 



170 TETTER. 

form a scab, under which there is pus, which frequently eats 
deep into the flesh. This, however, is only the case with 
children of very bad juices, and those who live in very damp 
dwellings. 

6. The last variety of tetter with w^ich we become 
acquainted deserves particular notice. This seldom attacks 
young children, but mostly, young girls, before the com- 
mencement of menstruation. It appears always, at one or 
the other angle, which the wing of the nose forms with the 
cheek, in the form of a dark-red spot, in the midst of which, 
one or more pointed vesicles, containing pus, are formed, 
with a violent burning pain, and discharging a yellowish 
gray pus, the greenish scab of which, does not only eat 
into the skin, but also into the weak muscular parts, situated 
underneath, and into the delicate cartilage of the nose, pro- 
ducing frequently not inconsiderable injury to the nose and 
cheek. 

With children, the principal causes of tetter are inherited, 
medical or mercurial diseases, uncleanliness, dwellings, 
which are damp or near marshes, spicy food and spirituous 
liquors, embrocation of corrosive ointments, scrofula, en- 
largement of the abdomen, &c. 

The duration of the tetter varies, for the eruption fre- 
quently disappears of itself, and returns, goes from one spot 
to another, and often covers the whole body. 

As to the treatment of the disease, it does not differ 
much for the several varieties ; it is very simple, but some- 
times very tedious. A strict diet must be attended to, par- 
ticularly by the mother, when the infant is affected w T ith 
tetter, she should avoid every thing that can be injurious. 
For children milk only, or farinaceous food, not too fat, is 
most salutary ; where there is enlargement of the abdomen, 
some meat, boiled fruit, and sour milk should be allowed. 



ENLARGEMENT OF THE MESENTERIC GLANDS, &C. 171 

The treatment itself, with children, is simple and successful, 
on account of the prevailing power of reaction, but the cure 
of that kind of tetter which depends upon predisposition 
becomes very tedious. 

The constant wearing of fomentations with a dry cover- 
ing over it, around the part which is affected by tetter, to 
be changed as often as they begin to get dry, is absolutely 
necessary ; also perspiring twice a day in dry or damp 
sheets. When the tetter on the body is extensive, and 
when the spots which it occupies are much irritated, burn- 
ing or itching, the patient should perspire in damp sheets, 
from one hour to three ; otherwise in dry sheets, after which 
he should be placed in a bath from 15° to 18° Reaumur 
(65|° to 72|° Fahrenheit), and left in it for five or ten 
minutes, and if the whole body is not covered with the 
eruption, he should be first rubbed with a wet, and then 
with a dry cloth. At the same time he should drink plenty 
of cold hydrant or spring water, and walk or be carried 
twice a day into the fresh air. 

During the first part of this radical treatment, the erup- 
tion generally increases ; when before it appeared insignifi- 
cant, it now spreads over the whole body, but soon dries up, 
and we may rest assured that it will not make its appear- 
ance again under any form whatever. 



ENLARGEMENT OF THE MESENTERIC GLANDS 

IN INFANTS. 

This disease manifests itself by frequent crying of the 
child, uneasiness, sleeplessness, vomiting of the mother's 
milk, just swallowed, enlargement and swelling of the ab- 



172 JAUNDICE. 

domen, in which we can plainly feel small lumps, and final- 
ly by costiveness. 

After slight perspirations twice a day, a bath of 18° to 
20° Reaumur (72|° to 77° Fahrenheit), which is to be re- 
duced daily two degrees, until we arrive at the natural heat 
of hydrant water, first during ten minutes, later during five 
minutes ; wearing constantly, well wrung cloths round the 
abdomen, a strictly regular diet of the mother, and remain- 
ing in the fresh air, will in a few days, overcome a disease, 
which not unfrequently is the cause of continued sickliness, 
and has proved fatal to a great many children. 



JAUNDICE. 

Of this disease, which attacks nearly every child, as soon 
as it is born, there are three varieties, that of the newly 
born infant, the acute, which is of short duration, and the 
chronic or bilious. Sometimes it appears in consequence 
of some other disease, inflammation of the brain, of the 
liver, bilious fever, etc. 

The treatment of the first variety, which always disap- 
pears quickly, when properly attended to, is very simple, 
natural evaporation in bed, then twice a day a bath of five 
minutes each, in water of 20° Reaumur (77° Fahrenheit), 
will in a few days effect the absorption and the secretion of 
the effused bile. 

The acute jaundice, which in a few hours, covers the 
whole body, as if it had been dyed, is generally connected 
with an irritable, febrile state. For this variety, sweating 
once or twice in wet sheets, for an hour and a half, follow- 
ed by a bath of from 18° to 15° Reaumur (72|° to 65f° 



JAUNDICE. 173 

Fahrenheit), and strong wet rubbing, is of essential 
service. 

Chronic jaundice is mostly caused by obstruction in the 
upper part of the alimentary canal, or of the mesenteric 
glands ; the abdomen is generally inflated, and costiveness 
accompanies it. This complaint, I have found to yield very 
soon to the following treatment. Cold fomentations should 
be applied and be changed as often as they begin to dry up, 
injections should be given, and the child should once or 
twice sweat in dry sheets, after which, it should be bathed 
entirely, in water of 15° Reaumur (6o|° Fahrenheit), from 
two to three minutes. If the disease is stubborn, recourse 
may be had to affusions, throwing the cold water from four 
or six small watering pots over the body. 

In all these cases we must pay attention that the patient 
drinks freely, and is brought into the fresh air. As to the 
kind of jaundice which appears as consequent upon one of 
the above named complaints, the treatment must be regula- 
ted according to the particular form of the disease, as soon 
as this latter is overcome, the jaundice will also disappear. 
The diagnosis of this complaint is very simple, for we re- 
cognize it by the color of the skin ; but generally it is pre- 
ceded by lassitude of the limbs, diminished appetite, a bit- 
ter taste, foul covered tongue, red and afterwards brown 
urine, and indolent stool ; the white of the eye turns a 
pale, and later a darker yellow, which appears mixed with 
red. 



INFLAMMATION OF THE THROAT. 

As the croup has already been described in a former 
chapter, I mean here by inflammation of the throat, only 
the inflammation of the cavity of the mouth, the tonsils, 
the veil of the palate, the cavity of the throat, the sub- 
maxillary and the parotid glands (mumps). 

This kind of inflammation occurs most frequently with 
children after taking cold, during damp weather, attended 
by catarrh and catarrh fever ; sometimes this disease appears 
general. Besides the diagnosis attained by the sight, the 
above mentioned parts appearing inflamed and swollen, 
particularly the parotid glands, where the swelling and 
inflammation reach a very high point, we also observe 
fever, alternating with heat and cold. The former soon 
begins to predominate, and deglutition becomes difficult, 
so much so, that frequently the patient is unable to swallow 
as much as the smallest quantity of water. 

The treatment should be regulated according to the de- 
gree of inflammation. In the beginning, or even when 
the part of the throat affected, is so much swollen, that 
swollowing has become difficult, but without much febrile 
action, a simple treatment will yet suffice : Washing the 
head and neck during the day, frequently, with fresh hy- 
drant water for four or six minutes, putting on a four-fold 
linen rag, which has previously been dipped in cold wa- 
ter, and in the beginning been slightly wrung, in the form 
of a cravat round the neck, from the tip of one ear to that 
of the other, changing it for another as often as it gets 
warm. This wet cloth must be carefully covered with a 
dry one, which latter, however, should never be drawn 
174 



INFLAMMATION OF THE THROAT. 175 

tight. At the same time the patient should take every ten 
or fifteen minutes, a mouthful of fresh water, and keep it 
in his mouth until it gets warm, when it may be spit out. 
Accordingly as the inflammation abates, the number of the 
ablutions should be diminished, the cloths round the neck 
be more thoroughly wrung, and only changed when they 
begin to dry up. 

When the inflammation and the swelling in the throat 
has made considerable progress, when the swallowing has 
become very difficult, when there is fever, and the skin is 
dry and hot, let the patient, in addition to the former treat- 
ment be wrapped up in slightly wrung linen sheets, which 
must be changed, as soon as they begin to get dry, that is 
to say if the fever has not abated. If this takes place, and 
the power of swallowing is not immediately restored, ablu- 
tions of the whole body twice a day should be added to 
the fomentations, and water in the mouth, also short affu- 
sions over the head and neck are of essential benefit. Very 
seldom, and only when there is danger of suffocation, from 
the violence of the swelling and inflammation, may the hip- 
bath, with constant rubbing of the lower extremities, be 
applied, and continued from five minutes to half an hour. 

But when the inflammation has already advanced so far 
that no resolution of the swelling of the almonds or parotid 
glands is possible, when one or the other of the glands has 
begun to suppurate, or threaten to become indurated, we 
should induce perspiration once or twice a day, from one 
hour to three ; followed by ablutions or affusions, besides 
the fomentations round the neck, which should only be 
changed when they have become almost quite dry, and the 
water, which should be kept in the mouth as long as pos- 
sible. During the whole period of inflammation of the 
throat, the patient must drink nothing but cold thin cow's 



176 INFLAMMATION OF THE THROAT. 

milk, and cold water, frequently, but only a little at a 
time. 

Inflammation of the throat, treated in this manner, will 
continue three days or more ; in the worst cases, as many as 
ten, but the patient will rarely be troubled again by the 
same complaint. 

Frank William W., six years old, a fair haired boy, of 
bloated appearance, and stout, was suddenly attacked by 
violent inflammation of the throat; mustard, leeches, poul- 
tices around the neck, sudorifics, resolvents, and purgatives, 
together with resolvent washes for the mouth, had been ap- 
plied without any good result, and when the danger had 
reached its greatest height, I was called in. 

The boy was in bed, very uneasy, a rattling noise in his 
throat, the head thrown back, whilst breathing very heavily 
through the nostrils. The head was affected, the look 
fixed, the mouth open as far as the swelling admitted, and 
the skin very hot. The thirst excessive, but could not be 
satisfied, because all that the patient put into his mouth, 
was again discharged by the nostrils. The fever was 
on the whole very violent. The two parotid glands were 
swelled to the size of a child's fist, and in their centre could 
be distinctly felt the fluctuation of pus, already formed. 
Only with great difficulty, and by the help of a silver spa- 
tula and a light, I succeeded in obtaining some idea of the 
state of the cavity of the mouth. I found the tonsils, the 
uvula and the soft palate so much swelled, that the two for- 
mer concealed the uvula between them, and closed the whole 
cavity of the mouth. Only by pressing down the tongue 
forcibly, an opening of the size of a small quill, could be seen 
in the throat, whilst on the left tonsil a white spot of the size 
of a lentil could be perceived. 

I immediately ordered a bath of 18° Reaumur (72|° 



INFLAMMATION OF THE THROAT. 177 

Fahrenheit), to be prepared, and after the boy's head, neck 
and breast had been washed, I had him placed in it, and 
left in it for ten minutes, whilst two attendants rubbed his 
body, hands and feet, with the flat of their hands. After 
this he was enveloped in a wet, slightly wrung, linen sheet, 
fomentations were applied to the head and throat, he was 
covered well up, and half a table-spoonful of water given 
every five minutes, although for the first six hours, he did 
not succeed in swallowing it entirely. During the first two 
days and the first night, the fomentations were changed 
every quarter of an hour, and later every half hour or 
every hour ; the enveloping was repeated every hour, the 
patient was then put into a sweat, and left in it for a whole 
hour ; after this he was quickly washed in cold water, and 
four quarts of water poured rapidly, with six intermissions, 
over head, neck and breast. Fomentations were then ap- 
plied close to the head and neck, and the patient put into a 
dry sheet. 

The above described treatment, that is to say, the sweat- 
ing and affusions were applied twice a day, which proved 
so successful, that already during the second affusion, one 
of the salivary glands broke, that the patient was able to 
open his mouth somewhat further, and to swallow a little 
milk, in fact, that he was out of danger. On the second 
day, also the left parotid gland opened, and discharged se- 
veral table-spoonfuls of pus. Now the fomentations were 
applied less often, and the boy was obliged to perspire for 
two hours ; from the fourth day of the treatment, one hour 
twice a day, until the eighth day, after which only the fo- 
mentations around the neck and frequent gargling with fresh 
water were used. On the eighth day of the treatment we 
had the pleasure of seeing the child in good health, and of 
the inflammation no sign was to be seen, except a small 
opening, under the angle of the left lower jaw. 



HOOPING-COUGH. 

The hooping-cough is a contagious disease, for the most 
part prevailing as an epidemic, most commonly attacking 
children between the age of one and seven years. It mani- 
fests itself, in shorter or longer returning paroxysms of a 
cough, accompanied by a peculiarly whistling tone and 
several expirations, succeeding each other rapidly, followed 
by one slow and troublesome inspiration, and attended with 
retching, or actual vomiting of a tough mucus. Generally 
the hooping-cough attacks several individuals at once, but 
more girls than boys, and particularly those of a delicate 
constitution and of great excitability. I have, however, 
no recollection in my practice of any case of hooping- 
cough, where an individual was attacked a second time. 
After all the observations which have been made on the 
subject, it appears that the appearance of hooping-cough, 
depends entirely upon atmospheric circumstances, wherefore 
the South is more frequently visited by this complaint than 
the North. 

In the hooping-cough w r e may observe three stages ; the 
first, its beginning, the catarrhal stage; the second, its 
height, the convulsive stage ; and the third, that of its de- 
cline. At the beginning of the first stage, the child be- 
comes fretful, weak, sleepy and chilly, the eyes become red 
and tears run from them, with accession of sneezing, which 
frequently induces persons to take it for a cold in the 
head. 

The cough appears in paroxysms, whilst the face looks 
bloated, it is dry, and sounds hollow and clear, the sleep 

178 



HOOPING-COUGH. 179 

becomes uneasy, the appetite small, the febrile action varies 
much. 

After the cough has lasted from one week to three, it 
begins to return in paroxisms of long duration, particularly 
towards the evening. The patient becomes more uneasy 
during the night, the cough is attended with greater irrita- 
tion, sounds much clearer, and after a while assumes a 
whistling tone. The child frequently makes a motion with 
its hands towards the throat, as if it wanted to rid itself of 
something troublesome, whilst a cold sweat appears on its 
forehead. Before the beginning of the paroxism, the child 
becomes so uneasy, that it seeks anxiously for some ob- 
ject, generally for the mother, clings to her, and, as if to 
escape from the attack, tries to hide with her. 

When the hooping-cough has reached its climax, the pa- 
roxisms succeed each other so rapidly, that inhaling becomes 
impossible, and that suffocation seems to threaten. The 
face now becomes dark red, changing sometimes to blue, 
the eye of the child is generally turned upwards, wanders 
about unsteadily, tears flow copiously, the pulsation of the 
exterior arteries is visible, and the veins at the throat 
swell ; sometimes the blood enters the conjunctiva of the 
eye and escapes through the mouth, nose and ears; still 
more frequently the children sneeze, a copious cold sweat 
covers the face, neck and breast, and involuntary voiding 
of the faeces takes place. Sometimes the too violent exer- 
tion causes rupture and prolapse. During the paroxisms of 
cough, which succeed each other rapidly, sudden retching 
or vomiting make their appearance, after which the cough 
either stops .entirely or abates. The child feels fatigued, 
and frequently complains of pains in the chest. The dura- 
tion of the complaint varies from one to several weeks. 
When it continues longer, however, it generally causes 



180 HOOPING-COUGH. 

emaciation, and ultimately, death. I have also seen cases 
where the complaint changed to bronchitis or croup, and 
death ensued from suffocation. When the complaint is 
treated hydropathically, this termination is not to be ap- 
prehended. 

During twenty-two years, many cases have occurred in 
my practice, which I have treated in different ways, but 
I must say that I give the preference to the hydropathic 
treatment, as by this, the disease always terminated quickly 
and favorably. 

The third stage, that of the decline, commences, when the 
paroxisms of cough diminish in number, in duration and in 
intensity ; when the cough becomes less dry, sounds less 
hollow, and less metallic. The inspiration and expiration 
become freer, the skin is more moist and disposed to per- 
spire, and vomiting less frequent. 

During the first stage of the hooping-cough, rubbing the 
body once or twice, and at most three times, with a wet 
linen cloth, then affusions from a watering pot, and cold 
fomentations, with cloths that have been well wrung, co- 
vered with dry cloths, which are to be changed every fifteen 
or twenty minutes, and frequent drinking of cold water 
are sufficient to overcome the disease, at most, in from six to 
ten days. 

During the second stage, according to the duration and 
violence of the paroxisms, perspiration in a damp sheet for 
an hour or an hour and a half must be produced, once or 
twice every twenty-four hours. After this the child must 
be washed immediately, or when there is much irritation to 
vomit, must have rapid affusions of from five to six quarts 
of water over the head, breast, and neck, with six or eight 
intermissions ; the fomentations must be worn round the 
neck as in the first stage. The result of the treatment in 



ITCH. 181 

this stage, is in a manner instantaneous, for, as soon as the 
physician, who is called in, after the first perspiration, ap- 
plies affusions, the disease seems to be checked at once in 
its violence, and decreases at every fresh affusion. 



CONVULSIONS. 

In children, particularly when nervous, convulsions are 
easily arrested, by washing, bathing, making affusions, en- 
veloping the whole body or the abdomen, succeeded by 
friction and frequent injections, the temperature of which 
must be regulated, according to the strength of the child 
and its irritability. The manner of applying the water, that 
is, the washing or the affusions, &c, must be agreeable to 
the duration, succession and intensity of the convulsions, 
which generally manifest themselves by twitching of the 
muscles of the face and of the limbs, or by tearing pains in 
the abdomen. When the paroxisms are slight, washing or 
a bath once or twice a day, is sufficient, whilst, when the 
convulsions return often, and are of long duration, we must 
use three envelopings in damp linen sheets and subsequent 
affusions. When teething or worms appear at the same 
time, we must follow the treatment, which will be indicated 
hereafter. 



ITCH. 

Of this eruption, we have three varieties, the dry or wool- 
itch, the moist, and the purulent ; it is a tedious complaint 
which can be communicated by contact, inocculation, and 
wearing the clothes of persons affected with the disease. It 
manifests itself in the form of small gritty vesicles, which, as 

16 



J 82 ITCH. 

soon as they appear on the surface of the skin, dry up im- 
mediately. This kind is called the dry itch, it is the most 
common, generally arises from uncleanliness, particularly 
with the wool-carders, wherefore it is called the wool-itch ; 
or it forms visicles, which contain a transparent fluid, when 
it is called the moist or greasy itch. When the vesicles run 
together and form a crust, under which matter collects ; it 
is called the purulent itch. This complaint manifests itself 
by a painful itching : which in the cold, is felt less, but which, 
at a high temperature, is very disagreeable, nay becomes in- 
sufferable, preventing those who are affected with it, from 
sleeping for whole nights. 

The itch, or properly speaking, the virus of the itch, 
(psora), a germ, imperceptible to the naked eye, producing 
millions and millions of minute vesicles, which cover the 
whole body, is not limited to the exterior skin, but pene- 
trates into the masses of the fluids, and produces an impor- 
tant effect upon the human body, by causing other diseases. * 
For, according to the latest discoveries of hydropathy, when 
the itch has been badly healed by the application of exter- 
nal remedies, such as unguents and baths, the virus recedes, 
remains for many years in the body, disturbs its health in 
various ways, and may become the cause of a host of dis- 
eases. It may produce predisposition for swelling of the 
joints and lymphatic tumors, insanity, &c, of which we 
have numerous authenticated instances on record, in later 
times, and of which every hospital will furnish abundant ex- 
amples, as there are always plenty of patients, afflicted with 
this disease. 

The cure of the itch is, although slow, particularly when 
of longer standing, at any rate safe and thorough, which is 

* In my " Botanical Practice," I shall therefore devote particular at- 
tention to Cutaneous diseases. 



SCALD-HEAD. 183 

all important ; and the virus which may have been concealed 
in the body for years, is driven to the surface. 

The first condition to cure the itch, is great cleanliness, 
wherefore all the linen worn on the person, as well as the 
bed-clothes, should be changed immediately. The patient 
must avoid all sharp, spicy, sour, fat victuals, and all spiritu- 
ous liquors; he must take plenty of exercise, principally in the 
open air, and drink freely of water. Accordingly as the 
itch is more or less general, the patient should be enveloped, 
once or twice a day, in damp linen sheets and blankets, and 
left one, two or three hours to perspire, during which time 
he should not drink. When the patient has perspired suf- 
ficiently he should be put in a bath of 10° to 15° R. (54|° to 
65|° F.), and left in it until the chills appear, when he must 
be well rubbed, and be allowed to go into the fresh air. Be- 
sides this, strong friction over the whole body, with damp 
linen cloths, once or tw T ice a day, is necessary. If crusts or 
scabs have formed, they should be covered with cloths, 
steeped in water, well wrung out, over which dry ones have 
to be placed. 

SCALD-HEAD— (Porrigo.) 

This eruption usually arises from uncleanliness in the 
mother, from mercurial or syphilitic diseases, from neglected 
leucorrhcea, the acrimony of which, the child imbibes with 
the milk. It generally appears on the scalp of the head, but 
sometimes extends to the face and other parts. 

The eruption begins with a few single minute pustules : 
they rise but little, or not at all, above the skin, in the begin- 
ning form little perforated scabs, through which the single 
hairs pass, afterwards coalesce and penetrate into the skin 
underneath. 



184 colic. 

Weaning the child from the breast, which it has hitherto 
sucked, giving it another, or feeding it, frequent perspiration, 
followed by washing, and covering the affected parts with 
linen pads, steeped in a mixture of half water and half milk, 
are the safest remedies, to free the child as soon as possible 
from its torments. 

Eliza R., seven months and a half old, was pale and thin, 
the head and half the face were covered with a whitish or 
grayish yellow thick scab, disfiguring the child most horribly. 
After many inquiries, the mother admitted that a considerable 
time before pregnancy, she had a leucorrhoea, which during 
that period had become worse, but which for the last few 
weeks had diminished. At the same time she admitted that 
during pregnancy, particularly during the first stages,she had 
a peculiar longing for salt victuals, wherefore she had 
eaten almost nothing but smoked meat, sardines, or herring. 
To the eating of so many acrid things, I attributed the aggra- 
vation of the leucorrhoea. 

The child was weaned, and given to a healthy nurse, to 
suckle it, and the diet of the mother regulated, the child, as 
well as the mother, had to perspire and bathe, the former for 
six and the latter for ten weeks. Fomentations of milk 
and water were applied to the head, and both child and 
mother recovered entirely, after the above mentioned periods. 

COLIC. PAIN OR SPASMS IN THE BOWELS. 

This complaint differs much in its nature. It may arise 
from inflammation, costiveness, accumulation of undigested 
food in the stomach or small intestines,* mucus, worms, 



* Called saburral-colic. 



colic. 185 

flatulency,or from intus-susception (the sheathing of one part 
of the intestines into another) and the use of lead (the paint- 
er's colic). 

A colic with inflammation, manifests itself by violent 
sharp cutting pains in the intestines only, or around the 
navel, increased by the slightest pressure, and is accompa- 
nied by an increased temperature of the skin and great thirst. 

Cold ablutions, at least every two hours ; wrapping up 
the whole body in wet sheets ; fomentations, with cloths not 
too thick, renewed every ten or fifteen minutes, over the 
abdomen, and frequent drinking of water, will remove the 
complaint in a few hours. 

Colic, from costiveness and saburral colic, are very simi- 
lar, the latter also is connected with costiveness, but in the 
former, sometimes there is no evacuation from the bowels 
for many days, whilst the latter, the saburral colic, easily 
changes its character. The symptoms of this complaint are 
eructations, sickness of the stomach, inclination to vomit, 
actual vomiting, pains with a rumbling noise, mostly under 
the region of the navel, whilst the abdomen feels hard, knot- 
ty, uneven, and tumid, and the hardened faeces can be felt 
in lumps in the region of the colon and the rectum. In this 
complaint pressure causes but little pain, and flatulency is 
but a rare symptom. 

The mucus and the worm-colic are always caused by ex- 
cess of mucus or accumulation of worms in the alimentary 
canal. The former is seldom very violent, but generally 
lasts long. The abdomen is tense and full, sometimes 
doughy and soft to the hand, and accumulation is distinctly 
felt. The stool is generally loose and mixed with mucus. 
The worm-colic which is caused by an excessive quantity of 
worms, principally attacks children ; the pain comes and 
disappears suddenly, it is felt generally about the navel, 

16* 



186 painter's colic. 

mostly during the night, and is boring, gnawing, pinching. 
This complaint appears with many other symptoms, indi- 
cating the existence of worms in children. 



FLATULENCY. 

This complaint is caused by the generation of gas in the 
stomach and in the intestines, the cause of which is gener- 
ally to be found in a particular weakness of the alimentary 
canal. The air, which is there produced, consists principally 
of carbonic acid and hydrogen-gas. 

In this kind of colic, the abdomen is distended, frequent 
rolling is perceived, and the drum- like, hollow sounding 
bowels, feel tense. The pains come and disappear rapidly, 
and rise upwards towards the stomach, and even as high as 
the chest, causing anguish, oppression, shortness of breath, 
eructations and inclination to vomit. Generally it is accom- 
panied by costiveness, and relief is obtained by discharging 
the flatus. A certain sign of distinction between this kind 
of colic and inflammatory colic, which it resembles much, is, 
that when in colic from flatulency, the abdomen is rubbed, 
the pain does not increase, but on the contrary, often dimin- 
ishes. 

PAINTER'S COLIC, 

Frequently occurs with children of potters, tin-men, 
miners, dyers, &c, from the effect of leaden ore, also from 
drinks which have been adulterated with lead. 

The sick child complains of violent pains in the abdomen, 
which frequently extend to the limbs ; it writhes, screams, 
whilst the abdomen, the hands and the feet are drawn in. 



INVAGINATION. 187 

This contraction is sometimes so great that the fingers are 
compressed in the hands, the feet drawn entirely up to the 
abdomen, the hands turned, and the abdomen feels perfectly 
flat, and very often presents a cavity. At the same time 
the patient feels very feeble, is sick of the stomach, vomits a 
greenish, bitter fluid, and always suffers from costiveness. 



INVAGINATION, INTUS-SUSCEPTION. 

This complaint consists, as we have mentioned before, in 
the pushing of one part of the intestines into another, and 
turning over. It is caused, either by accidental circumstan- 
ces or accumulation of worms, and endangers the life of the 
child. Generally, the lower part forms the sheath, but 
sometimes the upper part, which is far more dangerous. 
This complaint, which arises generally after a quick motion, 
when the stomach is full, manifests itself by a peculiar con- 
fused look, inclination to vomit, vomiting of the contents of 
the stomach, of mucus, bile, and finally of fecal matter. 
The intestines from above are over-filled to a certain extent, 
whilst a continuous drawing pain appears, which is increas- 
ed at every motion of the body. The intestines in this con- 
dition feel like sausages. 

The treatment of colic from costiveness, from accumula- 
tion of feces, from mucus, worms and flatulency, does not 
differ much, and the modifications which are necessary in 
single cases, depend solely upon the violence and the dura- 
tion of the complaint. The conditions in this case are : 1st, 
to call forth great activity in the alimentary canal. 2d, to 
thin the contents, w T hich cause the colic, and to clear the 
intestines of them. The first is obtained by fomentations 
on the abdomen, to be renewed as often as they become 



188 INVAGINATION. 

warm, by hip and half baths, to be taken every three minutes 
to every half hour, whilst constant friction is applied to the 
lower limbs and the abdomen. The second object is ob- 
tained by giving the child frequently cold water to drink, 
and from every two hours down to every half hour, half and 
whole injections alternately. This treatment in all such 
cases will quickly prove successful. 

The history of the following cases of painter's colic and 
of invagination will afford an easy survey of the treatment 
of these complaints. 

Anna Maria Stein, eleven years old, had complained, for 
several days, of pinching pains in the abdomen, and draw- 
ing pains in the limbs, when, during the night, she was sud- 
denly attacked by violent pains in the abdomen and con- 
traction of the limbs. 

When I saw the patient, her face looked disturbed and 
rather yellow, her tongue was dry. She complained of a 
tearing headache, palpitation of the heart, obstinate consti- 
pation and violent burning, when making water. The skin 
was dry and wrinkled ; during the paroxism the abdomen 
was contracted a little, and the limbs drawn up convul 
sively. 

I recognized this to be a case of painter's colic, and or- 
dered the child to drink frequently of a mixture of half 
cow's milk and half well-water, injections of the same, one 
every hour, fomentations around the abdomen, which had to 
be changed as often as they commenced to get dry, and 
every two hours, a wrapping up in wet linen sheets. Already 
after the first enveloping, there was some alleviation, after 
the third, a copious perspiration appeared. I then ordered 
the patient to have two gallons of water poured over her, 
and to have her rubbed ; after which she was put to bed, 
and having got warm, the proceeding was renewed. 



INVAGINATION. 189 

In consequence of this treatment, I had the pleasure of 
seeing the patient walk about quite well, on the third day. 

Henrietta Baum, a fair-haired, blue-eyed child, of a deli- 
cate frame, five years of age, of bloated appearance, who 
had been suffering from worms for a considerable time, com- 
plained shortly after a sudden leap, of violent pains in the 
right side under the navel. As the application of numerous 
remedies had not diminished the pains, but as these had 
been rather aggravated, I was called in after the evil had 
already existed for eighteen hours. The face of the child 
was sunk, badly disfigured, the look anxious, confused, and 
expressive of the greatest anguish ; there was a continua- 
tion of bad eructations, interchanged with real vomiting of 
mucous bile, mixed with single fragments of the faeces. 

The child complained of constant pain under the navel, 
more towards the right side, which were increased by the 
least motion. From that side upwards, the intestines could 
be distinctly felt, like big swellings, whilst from time to 
time, a little brownish excrement, mixed with mucus was 
voided. 

Considering this a colic, caused by the invagination of a 
portion of the ilium, and perceiving the danger to which every 
delay would expose the life of the child, I exerted myself 
to increase the peristaltic motion, both upwards and down- 
wards, in order to effect a separation of the parts invagina- 
ted, and at the same time to relieve any inflammation, which 
might already exist. 

The patient was immediately undressed, placed in an 
empty tub, and cold hydrant-water was constantly handed 
to her to drink. Whilst the head and the upper part of the 
body were supported by some person, two other persons 
rubbed the abdomen and the feet thoroughly, and I poured 
incessantly, by means of a large vessel, water over the abdo- 



190 INVAGINATION. 

men and the thighs, which I continued for half an hour 
The water being all the while thrown out, in such a manner 
that the child was always in an empty tub. In the meai 
time, small injections of cold water were given every quartei 
of an hour. Notwithstanding the continuation of this treat' 
ment, the invagination remained, but as the child on th 
whole, felt much easier, as all the threatening symptoms 
had partially disappeared, and it was shivering with cold 
I ordered this treatment to be discontinued for the mo- 
ment. 

Fomentations were now put round the abdomen, an injec- 
tion was administered, she was brought to bed and well 
covered up. Half an hour after, when the child had got 
somewhat warm, the above treatment was repeated. Scarce- 
ly had I continued this for a quarter of an hour, when the 
patient, with a violent jerk, discharged a great deal of wind 
of a cadaverous smell, which was immediately followed by 
lumps of feces, in which there were rolled up ten maw- 
worms. After this discharge, the child immediately felt 
easier, and the violent pain, as well as the vomiting ceased 

After this crisis, I had the child brought to bed, and we 
gave her some thin milk, with sugar and the yolk of an egg, 
which she did not throw up any more. From time to time, 
we gave her fresh hydrant-water to drink, and every half 
hour placed a well wrung cloth over the abdomen and gave 
an injection ; this we continued until evening. For the 
night however, as all the symptoms had improved, we only 
kept the fomentations on the abdomen, which were but 
rarely changed. The next morning, I found the child quite 
lively, playing in bed. I made it take, for a few days lon- 
ger, daily, a couple of half-baths, at 15° Reaumur (65|° 
Fahrenheit), of three minutes, and made it drink plenty of 
fresh water. As the child was perfectly well, and no symp- 



SANGUINEOUS TUMOR. 191 

toms of the previous complaint remained behind, I left, giv- 
ing the parents some directions for its diet, and I have heard 
a few days ago, that having followed them, the child has 
continued in good health ever since. 



SWELLING OF THE HEAD OF THE INFANT. 

This is a swelling, caused by pressure, during difficult 
and tedious labor, on some part of the head, in consequence 
of mal-formation of the pelvis, insufficient labor pains, too 
small an opening of the mouth of the uterus, resistance of 
the vagina, or of the use of instruments. It is a circum- 
scribed colorless humor with fluctuation. 

Small four-fold linen pads, steeped in cold water and well 
wrung, applied as fomentations, will remove this complaint 
in a few days. 



SANGUINEOUS TUMOR OF THE HEAD OF 

INFANTS, — (Cephalhematoma) . 

A swelling which is frequently mistaken for the above 
described, in new-born infants^ which generally is situated 
on the head, mostly on the right parietal bone, and appears 
in those who are subject to rachitis and scrofula ; it is sharply 
circumscribed. This tumor distinguishes itself from the for- 
mer by being small, during the first twenty-four hours, 
scarcely of the size of a hazel-nut ; by the third and 
fourth day it spreads gradually over its base, is elastic, later, 
rather flabby, hot and of a bluish color. On a closer inves- 
tigation near the base, the bone is apparently rough and 
swollen, which however is not the case, the sense of feeling 



192 LYMPHATIC SWELLINGS. 

being deceived here by the sugillation of the circumscribed 
fibrous membranes of the skull. 

Compresses of the size of the palm of the hand, doubled 
six times, dipped in fresh water, and slightly wrung, should 
be tied tight to the child's head by means of a cap of silk 
oil-cloth. Should this not remedy the evil, small pig's blad- 
ders, filled with ice, will generally resolve the tumor in 
from twelve to eighteen days, if at the same time we bathe 
the child twice a day. If this does not succeed, and the 
swelling will not yield, an incision should be made, the 
blood contained therein, be let out, and the child, whilst it 
receives the good milk of the nurse, be treated as above. 



LYMPHATIC SWELLINGS. 

In consequence of the small degree of vitality, which we 
find in those parts, where the lymphatic swellings have their 
seat, the inflammation which accompanies them, proceeds so 
slowly, that frequently it is scarcely perceived, nay, often 
remains unnoticed altogether, and is not discovered, when 
they have already attained an unmanageable size. 

For this reason, and on account of the small degree of 
vitality and warmth which they develope, they are also 
called cold swellings. They arise generally, when no exter- 
nal injury is the cause, from morbid dispositions, scrofula, 
gout, syphilis, scurvy, and complaints from mercury and 
iodine. The disease is preceded, without any local symp- 
toms, by general bad humor, want of appetite, easily be- 
coming fatigued, uneasy sleep, certain feelings, like pricking, 
&c. On any part of the surface of the body, generally on 
the neck, between the shoulder-blades, on the back, in the 
small of the back, on all the joints, but principally on the 



LYMPHATIC SWELLINGS. 193 

knee joint, on the upper part of the thigh, particularly on 
the breech, where the crease is, close behind the great troch- 
anter, a small flat elastic swelling is felt. It is very trifling, 
fluctuating in the beginning, like the adjacent skin and af- 
terwards becomes a nut-color, scarcely ever pains, at most 
producing an indistinct feeling of tension and weight. 
Several such swellings occur, very frequently, at the same 
time, particularly on the neck and in the small of the back. 
If a single one appears, it gradually reaches a considerable 
size, in which the fluctuation becomes more and more 
distinct, whilst the general health is more affected. 
The covering of the tumor, that is to say the skin, becomes, 
more tense, its color changes still more, and at last becomes 
a purple, the pains increase, whilst the strength of the pa- 
tient decreases, febrile action becomes perceptible, and the 
appearance of the patient becomes unhealthy. 

The skin, spread over the swelling, becomes evidently 
thinner, and at last an opening is formed, from which a thin, 
purulent fluid, often having a cadaverous smell, is discharged; 
this is followed by a clear fluid, and if the destruction of the 
bone has already commenced, by an ichorous discharge. By 
the large quantity of matter which is formed by excessive 
perspiration and diarrhoea, which appear at the same time, 
the physical strength of the child is soon worn out, and it 
dies of emaciation, in consequence of this lymphatic swel- 
ling. 

The above described kind of swellings is caused, where 
the predisposition exists, if no external injury has been re- 
ceived, by a determination of lymph towards a part. The 
abnormal extension of the walls of the lymphatic vessel, af- 
fected by this determination, .causes a rupture of the vessel, 
by which the lymph is effused into the surrounding parts of 
the tumor, which has been formed, gradually increasing their 

17 



194 LYMPHATIC SWELLINGS. 

size. The adjoining, solid soft parts, are destroyed by sup- 
puration in consequence of the said effusion. 

These swellings, if they cannot be resolved, change to in- 
durations, which, being themselves unwholesome, cause also 
inflammation and suppuration, scirrhus and cancer ; other- 
wise they become suppurating sores. 

The treatment should resemble that of the hip disease, in 
the second and third stage, and for its examplification, I 
add the following history of a case in point. 

Adolph Frolich, the son of the district engineer, eight 
years of age, of sickly and weakly parents, himself sickly 
since infancy, and frequently troubled with scrofula, slim, 
but bloated in the face, otherwise lively, commenced sud- 
denly to complain of stiffness in the joint of the right knee. 
As the parents could not observe anything, and were ac- 
customed to hear the child complain, it remained for several 
days unnoticed, until the boy said, that he could not walk, 
because it hurt him. On examining the child more par- 
ticularly, the father found at the utmost edge of the knee- 
pan, rather upwards, an elastic swelling, of the size of a 
small hazel-nut, which on the second day, was followed by 
a second one, on the opposite side, farther up, which like 
the first, disappeared when strongly pressed. 

The parents became uneasy, and sent for their physician, 
who prescribed some powders and some aromatic fomenta- 
tions of wine- vinegar. After having used these remedies 
for several days, the swelling spread gradually over the 
whole joint, and the violence of the pains increased. After 
this, leeches and mustard blisters were applied for a fort- 
night, and the tartar emetic ointment rubbed into the knee. 
Over the knee warm fomentations of hemlock, henbane and 
flax-seed, which were to act as resolvents, were put, and 
antimonv, calomel, and iodine prescribed to be taken, in- 



LYMPHATIC SWELLINGS. 195 

wardly, and also to be used as an embrocation. As all this 
did not arrest the disease, I was consulted about six weeks 
after its commencement. 

I found the child already in a feverish state, the exacer- 
bation of which towards evening was very violent, perspira- 
tion appearing regularly after midnight ; the face, as well 
as the whole skin, through which the little veins were visi- 
ble, was pale and bloated ; the right knee was considerably 
swelled, the skin shining and transparent, traversed by blue 
veins ; in some spots the skin had been removed by the re- 
medies, which had been applied, in some there was consi- 
derable suppuration, and the whole leg was drawn up, so 
as to form an acute angle, the patient finding it impossible 
to stretch it out. In three or four places the fluctuation 
was distinctly perceptible, and in one of them the skin so 
thin, that a breaking might be expected shortly. At the 
same time the patient was very low. 

The complaint was recognized as an affusion of lymph 
into the knee-joint, which had caused a so called White 
Swelling. I commenced the following treatment imme- 
diately. 

I had the patient every day, at five in the morning, and at 
three in the afternoon, wrapped in a well wrung linen sheet, 
(after he had, on the first application, been washed with 
tepid water,) had him covered well, and allowed him to per- 
spire slightly in it. After this I caused him to be put into 
a bath of 15° Reaumur (65|° Fahrenheit), in which he 
continued for five minutes ; he was then well rubbed, first 
with a wet linen cloth and afterwards with a dry one. 
This rubbing was repeated at eleven o'clock in the morning 
and at eight o'clock in the evening, in such a manner, that 
the wet friction always lasted a couple of minutes, after 
which he was put to bed. During the rest of the day and 



196 LYMPHATIC SWELLINGS. 

of the night, an ox-bladder, half filled with pounded ice, 
was worn over the affected knee. The food consisted of a 
nourishing meat and of cold hydrant water, and as often as 
possible, the patient was carried into the fresh air. 

After three days, the spot, where the fluctuation was 
greatest, opened at night, and more than half a pint of yel- 
lowish water, mixed with some pus was discharged. This 
continued for several days, but the discharge diminished in 
quantity, became gradually thinner, and smelled very bad. 
Continuing the former treatment, I ordered the knee to be 
syringed four times a day successively, with a small syringe 
with ice water, without removing the water by pressure out 
of the cavity of the knee, after which a single piece of linen 
was placed upon the opening, and the application of the ice 
in the bladder was continued. At the same time, as soon 
as the discharge had taken place, I insisted upon the 
child's attempting, several times a day, with the assistance 
of somebody, to stretch the sore leg more and more. 

After a fortnight, the sick child had evidently gained 
strength, the movement of the knee was perceptible, and the 
swelling decreased considerably. I now let the little patient 
sweat twice two full hours a day, for eight days, with pro- 
gressive augmentation ; afterwards I let him take a bath of 
three minutes ; then followed an affusion, principally over 
the knee, which latter was repeated twice a day, after the 
friction had been used, besides, when applied with the bath ; 
all the rest was continued as before. 

The boy improved evidently as well in strength, as also 
in respect of the sore leg. Six weeks after the beginning 
of the cure, an eruption appeared, and hundreds of pustules 
covered the whole body of the child, which were of the 
form and character of boils, but differing in size, most of 
which began gradually to suppurate. From that time for- 



HISTORY OF A PROLAPSE OF THE RECTUM. 197 

ward, the swelling at the knee diminished, and after I had 
discontinued the syringing entirely, the opening in the skin 
healed. The swelling of the knee was gone, except some 
enlargement of the heads of the bones, and the boy, eight 
weeks from the beginning of the treatment, was able to walk 
about the room, with the assistance of a stick. After six 
weeks, at the time of the breaking of the boils, I discon- 
tinued the application of the ice, and substituted cold damp 
cloths, which were changed as often as they began to get 
dry. These fomentations were continued after the boy 
began to walk. About ten weeks after the beginning of 
the above treatment, the little fellow was perfectly well, 
when I merely recommended to wash the whole body, and 
to make cold affusions over the right knee, every morning 
for a month longer. 



HISTORY OF A PROLAPSE OF THE RECTUM. 

From too violent screaming, and straining at the fruitless 
urgency to stool, the child of Charles Aulich, carpenter, 
two years old, had a prolapse of the rectum. Three days 
after the occurrence of this accident, I was called in. 

I found the little boy suffering from the above mentioned 
evil, attended with costiveness, which had lasted several 
days, and distention of the abdomen. The protruding part 
measured about two inches, was turned and of a bluish 
color. I immediately ordered that the child should take 
nothing but some skimmed milk, and sugar and water, that 
it should receive every half hour a small injection of water, 
that it should take four hip-baths of a quarter of an hour 
each, and that cold fomentations should be put to the anus, 
which were to be frequently changed. 

17* 



198 MEASLES. 

After eight or twelve injections, three copious stools fol 
lowed, and the abdomen as well as the part prolapsed, be- 
came softer. I now slowly reduced the part, with a finger 
covered with oil, ordered the injections to be discontinued, 
but the hip-baths and fomentations to be repeated frequently, 
until the second day, when the child was perfectly well, and 
nothing of the accident could be seen. 



CRUSTA LACTEA. 

An eruptive disease like the scald-head, which arises from 
the same causes, and is similar in its course. It differs how- 
ever from the latter, by attacking only the head and face, 
instead of appearing in pimples, and of penetrating to the 
roots of the hair or the pores of the skin ; it forms one or 
more layers of scales, and distinguishes itself by small yel- 
lowish white pustules, arranged in groups and more or less 
confluent, changing to a crust, which is of a yellowish green, 
sometimes of a dirty brown color. 

The treatment is the same as in scald-head. 



MEASLES. 

This is a contagious complaint, which not unfrequently 
prevails as an epidemic, during the spring, and which as the 
old physicians assert, is, as such, a precursor of the natural 
small-pox. 

The eruption of the measles, attacks at the same time 
both the skin and the mucous membrane, as the internal li- 
ning of the respiratory and digestive organs, whence, in the 
beginning, frequent sneezing, with an acrid discharge from 
the nose, running of the eyes, and cough, also difficulty of 



MEASLES. 199 

swallowing, pains in the breast, and sore throat, fever heat 
and a troublesome thirst, a dry skin, and in the evening in- 
creased paroxysms of fever. Besides those premonitory 
symptoms, we have weakness, physical prostration, uneasi- 
ness, want of appetite and pains in the limbs. 

This eruption appears on the skin, in small red, slightly 
elevated spots, by which it is peculiarly characterized. In 
the beginning these spots appear divided, principally in the 
face like flea-bites, but soon join, and take the form of an 
irregular crescent, giving to the skin the appearance of being 
painted like marble. The spots in most cases are collected 
in groups, cover the whole body, and finally spread over the 
lower extremities. When the eruption has reached its 
beight, it lasts from three to four days, after which by the 
scaling of the outer skin, it terminates in about as many 
days as it commenced. An individual, who has once had 
measles, is, as a general rule, not liable to be again attacked. 
When the measles, in their course, are not malignant, and 
are not connected with a second disease, the treatment, un- 
der a diet of milk, and avoiding exposure to cold, is, simple 
ablutions once or twice a day, with water of from 18° to 
20° Reaumur (72±° to 77° Fahrenheit). This is perfectly 
safe and will prevent all after-diseases. At the same time 
the sick child should be kept in bed, neither too hot nor too 
cold. 

But, however favorable, the state of a person, who is at- 
tacked by one of the cutaneous eruptive diseases, may be, 
we should never allow ourselves to become too secure. In 
no complaints, but these cutaneous diseases, such as measles, 
scarlet fever and miliary fever, are changes for the worse 
so rapid, attacking principally the head the chest and the 
abdomen, and by receding, fall upon the brain, the respi- 



200 MEASLES. 

ratory organs, and the alimentary canal, endangering the life 
of the child. 

If therefore the physician finds, that the fever is too vio- 
lent, the skin very dry and hot, the head of the patient suf- 
fering from stupor, that he complains of boring pains in the 
region of the temples, that the eyes cannot bear the light, 
the thirst is not to be assuaged, breathing difficult, or when, 
cutting in the bowels with swelling of the abdomen and an 
aching, or even delirium makes its appearance, he should 
not delay, although the eruption had already formed and 
shown itself, to put the patient in wet sheets, to apply cold 
fomentations to the head, and to give him plenty to drink. 
After the perspiration has broken out, ablutions with water 
of from 10 to 15° Reaumur, (54J° to 65|° Fahrenheit,) are 
to be applied, and this treatment is to be continued, until the 
patient returns to the natural state. But when the disease 
has already reached the brain, we should not delay applying 
ice to the parts, (in other cases common cold fomentations 
will suffice), then let the patient perspire, and after that, 
bring him into an entire bath of from 10° to 15° Reaumur 
54|° to 65|° Fahrenheit), leave him in it from one to two 
minutes, whilst constant cold affusions are made over the 
head, then, wrap him wet in dry cloths and put him to bed, 
where the said applications on the head, must be continued 
uninterruptedly, and he must drink plenty of cold water. 

For any diarrhoea, which may remain behind, frequently 
renewed fomentations round the abdomen, should be applied, 
plenty of water be given to drink, and three or four injec- 
tions of water of 10° Reaumur (54|° Fahrenheit) be adminis- 
tered. In the worst case a lukewarm bath should be used. 

Louisa Keller, five years of age, was attacked by measles 
on the 21st May, with all the described premonitory symp- 
toms, which, after she had been ailing for three days, came 



MEASLES. 201 

out well, without any extraordinary symptoms, except that 
of considerable heat. 

After the parents had spent a sleepless night, on account 
of the heat of the child and wandering, which had com- 
menced after midnight, I was sent for to see the child. She 
was a girl with black hair, and dark complexion. I found 
great heat, her head much affected, falling from time to 
time into a profound sleep during which she kept constantly 
moving her fingers and raving ; tongue and lips were dry, 
breating difficult, the abdomen distended, the skin dry 
and burning hot ; the eruptions looked a pale red, and ac- 
cording to the report of the parents, had diminished much 
since midnight. Very thin feces and urine were discharged, 
very often involuntarily. 

I did not doubt but that the eruption had receded, and was 
about attacking the brain, wherefore I did not hesitate a 
moment to put an ice cap on the child's head, to tie well 
wrung cloths, as fomentations, round the abdomen, and to 
wrap the whole body in wet double linen sheets, besides 
giving her plenty of cold water to drink. 

Two hours later, there was an evident improvement, and 
the congestion of the head had much diminished, but as, 
notwithstanding, the little girl did not perspire, and the 
temperature of the skin reached again a height of 30° Reau- 
mur (99J° Fahrenheit), I had her again enveloped in linen 
sheets, quite wet, and renewed the fomentations. In two 
hours and a half, a considerable perspiration, and with it, 
evident diminution of all the dangerous symptoms appeared. 

I let the perspiration continue a whole hour, then had her 
put into a bath of 12° Reaumur (59° Fahrenheit), in which 
she was left for two minutes, whilst constant friction was 
applied. After this she was taken out, and three pitchers 
of water, containing each a gallon, poured over her head. 



202 MEASX.ES. 

She was then, with the fomentations round the abdomen 
wrapt wet in a dry linen sheet, put to bed, and well covered. 
The ice cap was continued. After this treatment, the erup- 
tion soon reached its height, the little patient became quite 
lively, and in the afternoon, I exchanged the ice cap for 
common wet fomentations, which were renewed, every 
quarter of an hour. In the evening the child was washed 
with water of 10° Reaumur (54|° Fahrenheit), and slept 
quietly the whole night. The second day the general health, 
with some little deviation from time to time, was good, the 
eruption was vivid, no further congestion occurred, I there- 
fore repeated the ablutions of the previous evening, only 
twice during the day, changed the fomentations on the ab- 
domen twice a day, and gave the child every three hours a 
small injection of water of 10° Reaumur (54 J° Fahrenheit). 
The diet consisted of mucilaginous soup. 

The night was again very quiet, without any interrup- 
tion, and in the morning it appeared that desquamation 
(scaling) had commenced. I now had the child brought, 
after slight perspiration, twice a day, in an entire bath of 
16° Reaumur (68° Fahrenheit), in which it was left for 
two or three minutes, and rubbed constantly. This treat- 
ment was continued for two days longer, and on the 26th 
May, the fifth day of the treatment, and the eighth since 
the beginning of the disease, the child was running about, in 
the room, and on the tenth in the open air. As a precau- 
tionary measure, I ordered the child to be well washed for 
several days more, on getting up in the morning, with water 
of 10° Reaumur (54|° Fahrenheit), and to be well dried, 
to which the child, who continued in perfect health, became 
afterwards habituated. 



INFLAMMATION OF THE EAR. 

This is an inflammation, which attacks the ear, either 
before or behind the tympanum, and is therefore divided into 
the external and internal inflammation of the ear. 

The external inflammation of the ear, with children, who 
cannot speak, can only be discovered by the existing redness 
and swelling of the concha, or auricle, (the outward ear). 
To discover the internal inflammation as long as the child 
cannot speak, and point out the seat of the pain, is however 
much more difficult. The physician is but too often led to 
take this disease for some other evil, and to treat it as such, 
endangering not only the health, but even the life of the 
child. The child not being able to complain, the physician 
frequently does not discover the real seat of the disease, 
until the afflicting result opens his eyes, when in most cases, 
it is too late. 

Altogether the inflammation of the ear is of an erysi- 
pelatous nature, masked under a form of catarrh or rheu- 
matism ; wherefore these cases appear more or less under 
the phenomena of this form, which, when the child cannot 
speak, will easily lead us astray. When the child speaks, 
we can obtain the proper information from its words. It is 
therefore important to attend to the most insignificant symp- 
toms, and to collect them, in order to obtain a proper diag- 
nosis of the disease ; which generally manifests itself in the 
following manner. 

The child, which is attacked by an internal inflammation 
of the ear, either of the lining membrane of the auditory 
passage, of the cellular tissue, of the periosteum of the same, 
or of the tympanum itself, is always crying, is very cross, 

203 



204 INFLAMMATION OF THE EAR. 

and sleeps very little. This sleep is interrupted by the least 
noise, from which the child awakes generally, with a loud 
scream, weeps, and is quieted with much difficulty. When 
the child is carried, is rocked in the cradle, or on the knee 
of the nurse, it cries only the more, frequently without any 
intermission, until it is quite hoarse or exhausted. When a 
child, which is attacked by a similar inflammation, is not 
yet weaned, it will frequently seize the nipple of the breast 
very greedily, but start back immediately with a loud 
scream, knock about its hands, and under similar other ges- 
tures try to seize the breast again. The pain, however, 
prevents it from sucking, and it falls away evidently. 

When the child is seven months or a year old, it bores 
with its head into the pillow, and turns the affected side 
towards it. On being carried, it leans its head with an 
evident expression of pain in the face, on one or the other 
shoulder of the nurse, and begins to cry as soon as an attempt 
is made to take it out of the position in which it feels more 
comfortable, rubs the suffering organ against the clothing, 
or with its little hands ; cries aloud at the slightest touch of 
it, and resists every further investigation. 

This kind of inflammation progresses rapidly, attacks the 
adjacent parts, the bone, even the membranes of the brain, 
and the brain itself. The disease becomes more and more 
threatening. The pulse which in the beginning had been 
febrile, becomes intermittent and gradually weaker, the face 
changes, the eyes turn, single twitchings of the muscles, 
convulsions, spasms, appear, the voice loses its sound en- 
tirely, the child only groans, it becomes stunned. The feet 
become cold, and death takes place from spasms, convul- 
sions or apoplexy. 

The treatment of the external inflammation of the ear, 
particularly in the beginning, is very simple, for wet fomen- 



INFLAMMATION OF THE EAR. 205 

tations, covered with dry cloths, to be changed as often as 
they become warm, will suffice. 

When the inflammation has farther progressed, or has 
attacked the internal auditory passage, we should apply, 
besides the fomentation, which must now be made over the 
whole temple, foot and hip-baths, lasting a quarter of an 
hour, every two or three hours. If these should prove in- 
sufficient, or the child should be too small, instead of them, 
half baths, every five or ten minutes. When the children 
are several years old, they should often take water in their 
mouths. When there is already fever heat, or if the pain 
cannot be otherwise allayed, the child should be wrapped up 
in cold damp sheets, which should be changed, whenever 
they become warm, and this be continued as long as the pain 
lasts or begins anew. 

If the child becomes quiet, which is a sign that the in- 
flammation has abated, let it be put into a moderate per- 
spiration, and remain in it for half an hour, after w T hich it is 
to be washed with water of 15° to 18° Reaumur (65| to 
72|° Fahrenheit). From this time forward the fomentations 
must gradually be less frequent. In case a purulent discharge 
should make its appearance, we should syringe the ear with 
water of 15° Reaumur (65|° Fahrenheit), three or four 
times a day, and take the same water for the fomentations. 

As to the diet, let the milk be slowly injected into its 
mouth, instead of allowing it to suck, or if it can already 
eat, give the pap, with a very small spoon, by which the 
child will be spared much pain. 

By treating inflammation of the ear in this manner, I have 
always succeeded in conquering the complaint soon. 

18 



PEMPHIGUS, 

Is a trifling eruption, which appears in separate patches 
or groups, on the surface of the skin, and which is charac- 
terised by small vesicles, containing a serous fluid. These 
vesicles, for the most part, appear first in the face, and upon 
the hands, sometimes single and dispersed, sometimes in 
groups. They terminate by a thin desquamation or super- 
ficial excoriation of the skin, or by suppuration when a pre- 
disposition for such, exists. The fever, which accompanies 
this kind of eruption, is trifling and of an irregular character. 
Pemphigus resembles much the vesicles in erysipelas, where- 
fore the one is often taken for the other ; the latter, how- 
ever differs essentially, the surface of the skin in erysipelas 
being shining and red and tense. 

Although this eruption, with old and feeble people, and 
in typhus fever, often takes a chronic form, with chil- 
dren, it always goes off quick and without any malignancy. 
All that is required, is, to keep the patient in a room, of 
which the temperature is from 15° to 18° Reaumur (65|° 
to 72 1 Fahrenheit), and to make him observe a strict diet, 
which should consist of some milk or fruit. In bed, the patient 
should be moderately covered, and he should keep the room 
for a few days. This simple treatment will be sufficient, 
when the fever-heat is inconsiderable, and the complaint 
will pass off in a few days. 

We may, however, give the patient plenty of cold water 
to drink, and after the eruption has been at its height, for 
one or two days, wash him once or twice a day, over the 
whole body with water of 16° to 18° Reaumur (68° to 
72|° Fahrenheit). If there is fever heat, if the skin is dry 
and hot, let the patient drink plenty of hydrant water, and 



CONTUSIONS. 207 

have him wrapped up in the usual manner in wet sheets, 
until perspiration occurs. 

This, generally, takes place after the second or third en- 
veloping, when at the same time the eruption makes its 
appearance, which soon spreads over the whole body. By 
employing ablutions, once or twice a day, with water from 
16° to 18° Reaumur (68° to 72!° Fahrenheit), the scaling 
will commence, and the patient recover. 



CONTUSIONS. 

In case one of the solid-soft parts has been lacerated, 
the wound should be freed from any foreign body, which 
might be in it, the large vessels, if there are any torn, should 
be taken up and tied, the parts which gape much, be sewed 
by a dry or bloody sutor (sutura sicca or sutura cruenta) 
and the parts which are divided or deprived of the skin 
should be covered with a wet linen rag. After this has 
been done, wet cloths, which in the beginning are but slightly 
wrung, are placed as fomentations over the whole of the 
contusion, loosely, without any other covering, and are 
changed as often as they begin to get warm. If this should 
be found insufficient, to allay the existing pain and heat, ice 
water, or pounded ice should be used. But as soon as the 
heat and pain decrease, we ought to return to the common 
cold fomentations, over which now dry cloths should be 
laid. Accordingly as the pain and the inflammation de- 
crease, and especially when suppuration commences, the 
wet cloths should be wrung dryer, and remain longer upon 
the contused part. The treatment must be continued, until 
the wound is entirely healed ; the time necessary, will de- 



208 ERYSIPELAS. 

pend upon the extent of the injury. That this method of 
healing, without any salves or plaster, is the safest and the 
shortest, I could prove by a thousand instances. 



ROSE-RASH. (Roseola.) 

An evanescent eruption of the skin, which, without any 
cause, and without any precursors, suddenly appears on the 
surface, in rose-colored, flat spots, in different parts, suc- 
cessively. It is mostly without any febrile action ; appears 
in the course of twenty-four hours, and disappears as fast as 
it comes. 

This eruption generally passes off without any functional 
disturbance, all that is necessary, as soon as it is observed, 
is, to keep the child in the room, in a moderate tempera- 
ture, and in case heat or, with sensitive individuals, fever 
symptoms occur, to make two or three ablutions of luke- 
warm water, and to let the child remain in bed. 



ERYSIPELAS. 

This is a superficial inflammation, with swelling and red- 
ness of the skin ; it may be divided into two kinds, the true 
and the false. The cause of the former generally lies in 
some derangement of the digestive organs, and in a morbid 
secretion of the bile. 

True erysipelas always commences with a fever, which 
in the evening begins w T ith cold and terminates with heat. 
Prostration, a bitter taste, inclination to vomit, with loss of 
appetite, headache, and thirst, are the premonitory symp- 
toms, which, at latest, in twenty-four hours, are followed by 



ERYSIPELAS. 209 

the appearance of erysipelas in some part of the skin, gen- 
erally in the face. The affected spot, the skin of which 
appears tense, becomes red and swells, and the pressure of 
the finger, leaves a mark behind. Often, after the expira- 
tion of a few hours, several vesicles of different sizes are 
formed, on the reddened surface ; these are filled with a clear, 
transparent, yellowish fluid, and frequently open in less than 
twenty-four hours ; when others form immediately in other 
parts of the body, though generally the seat of the disease 
is in the face as before observed. The true erysipelas passes 
rapidly through its different stages, particularly the postu- 
lous, which invades the face, and which disappears in one 
place, and immediately reappears in another, also frequently 
flies to some other organ, particularly the brain, when it 
becomes very dangerous. 

The false erysipelas occurs in consequence of external in- 
fluences, such as, cold, heat, a cut, stimulants. This kind of 
erysipelas differs in the manner of its commencement and 
its feeling, it seems doughy, is of a pale color, often with 
a bluish cast, and very seldom forms vesicles. 

Besides the two mentioned species of erysipelas, and their 
varieties, the detailed treatment of which I reserve for my 
work, which will shortly appear, the infantile erysipelas re- 
mains to be noticed, which frequently attacks children, 
during the first days of their existence, and sometimes as 
late as the tenth and twelfth week, generally preceded by 
miliary eruption and jaundice. The original cause of this 
is mostly to be found in the cutting of the navel-string, with 
a blunt pair of scissors, wherefore this kind of erysipelas 
frequently begins at some part of the navel, and thence 
spreads quickly over other parts of the body. Although 
according to the older observations, erysipelas in the face, 
partly on account of the adjacent brain, which very easily 
18* 



210 ERYSIPELAS. 

sympathizes with the eruption, partly on account of a dis- 
position to suppurate profusely, and to form tedious ulcers, 
as also that the violent inflammation changes so easily to 
gangrene, has always been described as dangerous, yet I 
have not had in my practice, for the last fourteen years, both 
in and out of hospitals, a single case, which has terminated 
fatally ; on the contrary, since I have commenced to use the 
water, I have always succeeded in checking the inflamma- 
tion early, thereby obtaining a safe cure. 

The treatment of the different kinds of erysipelas does not 
vary essentially, and is principally regulated by the degree 
of fever and the height of inflammation of the affected parts. 
These must be covered in proportion to the degree of 
inflammation, and sensitiveness more or less often, with 
well wrung fomenting cloths, over which dry ones, that 
lie close, are to be put. Care should be taken not to irritate 
the part too much by changing the fomentations too often, 
and expose the diseased limb or the whole body too long 
to the draught, thereby cooling it, and interrupting the ne- 
cessary and salutary evaporation of the skin ; this would do 
more harm than good. Perspiration is absolutely necessary, 
to resolve the erysipelas, and to cure the fever, and on sin- 
gle spots is induced by fomentation, but over the whole body 
by entire enveloping, which must be renewed as soon as the 
surface of the skin becomes dry, hard, and disposed to chap, 
or the heat in the linen sheets becomes unbearable for the 
patient. If in consequence of the enveloping, the skin be- 
comes gradually softer, and more moist, if even perspiration 
makes its appearance, this should be kept up by covering 
the patient well, and by his drinking frequently cold water. 
If this has continued from one hour to three, accordingly as 
it may be judged necessary, the patient should be washed 
with water of 16° to 22° Reaumur (68° to 81£° Fahrenheit), 



TETANUS AND LOCK-JAW. 211 

the local fomentations being applied, he should be wrapped 
up dry, and be well covered. Only when the skin becomes 
hot and dry again, or the fever and the local affection will 
not diminish, should the enveloping be renewed. During 
the whole time, attention should be paid that the patient 
drinks often cold water, that, in case there is any constipa- 
tion, it is remedied by half and whole injections, and by 
drinking one half sour and one half sweet milk ; as also by 
keeping a strict diet, and during the process of inflammation, 
eat nothing but clear broth or some milk. When the fever 
has passed its height, the patient may take some fruit, and 
later some preserves with wheaten bread. 

Respecting the treatment of the infantile erysipelas, I 
must add, that the sheets, for wrapping up the infant, 
should be of old fine linen, and adhere close to the skin. 
The child should be well covered, the heat be checked, and 
perspiration be induced as soon as possible. 



TETANUS AND LOCK-JAW. 

This complaint seldom appears alone, but generally con- 
sequent upon other diseases. With children it is mostly 
connected with worms, or with epilepsy ; with girls not un- 
frequently with chlorosis (green sickness) and very often 
in consequence of external injuries. 

This disease generally appears suddenly, without any 
other symptoms, as after chlorosis, with continued contrac- 
tion of the muscels. The body of the patient, during vio- 
lent pains, is bent either forwards, or backwards, or to the 
side, or it is stretched out perfectly straight. Before the 
attack commences, the child generally becomes uneasy ; 



212 TETANUS AND LOCK-JAW. 

difficult breathing, giddiness, palpitation of the heart, pres- 
sure in the stomach, disposition to vomit appear. 

During the paroxysm, which lasts for several minutes* 
sometimes for half an hour, the child remains speechless, 
and unconscious, and when the paroxysm has passed off, 
there always remains, a peculiar pricking, dull, lame feeling 
in the limbs. 

As to the treatment of the disease, we should pay parti- 
cular attention to remove the cause, for instance, worms, 
injuries of the sinews and nerves, foreign bodies in wounds, 
&c, whereby it must be modified according to each case, 

which occurs. 

As to the paroxysms themselves, we can only act upon 
them directly, whilst they last, and then, only with indif- 
ferent success, as long as the cause is not removed ; the 
most that can be done in this case, is a shortening of the 
paroxysms. 

Affusions over the head and back of the child in a tub, 
with constant friction and half baths, during which the pa- 
tient must also be well rubbed on the spine, on the hands 
and feet, render essential services ; principally the affusions, 
because they shorten the paroxysm. I have applied them 
in the following manner : 

I placed the child, which was attacked by tetanus or 
locked jaw, as soon as the paroxysm came on, into an 
empty tub, and whilst it was rubbed well and constantly, 
poured water over it, until the fit went off, or the child 
became stiff with cold, after this, it received one or two 
whole injections, was wrapped in dry cloths and left in 
bed, well covered, until perspiration broke out. After this 
it was washed with water of from 12° to 15° Reaumur (59° 
to 65|° Fahrenheit). This proceeding was renewed as 
often as the paroxysm reappeared. The parts, most affect- 



SCARLET FEVER. 213 

ed by tetanus, should be covered with well wrung foment- 
ing cloths, which are always to be covered with dry ones, 
and to be changed as soon as they begin to get dry. At 
the same time the child should drink plenty of cold water, 
and with lock-jaw keep it in the mouth. 

If worms are the exciting cause, besides the above treat- 
ment during the paroxysm, two or three hip baths from 10° 
to 15° Reaumur (54£° to 65|° Fahrenheit), of ten to fifteen 
minutes duration, accompanied by constant friction, should 
be administered, and the child should wear around the body, 
day and night, a wet belt, which is to be changed, when- 
ever it begins to dry up. 



SCARLET FEVER. 

This contagious disease, which mostly prevails as an 
epidemic, and which is so much dreaded, is no longer con- 
sidered as dangerous by those, who have made themselves 
acquainted with hydropathy. Experience has taught us in 
our times, that by the use of water, this malady can be pre- 
vented, the duration can be shortened, if it has already com- 
menced, and all the dangerous systems be overcome. 

Scarlet fever is a disease, which manifests itself by a pe- 
culiar kind of spots upon the surface of the skin of the 
human body, which appear as single, small, red dots, after 
a fever, of from one to three days. Soon, large, irregular, 
scarlet or raspberry-red spots take their place, which gra- 
dually spread over the whole surface of the body, and 
which, on the seventh or eighth day, terminate by desqua- 
mation (scaling) of the cuticle. The eruption is generally 
attended by sore throat. 

Scarlatina is mostly divided into four kinds; they 






214 SCARLET FEVER. 

consist, 1st, of the simple, mild, terminating regularly ; 2d, 
of that in which principally the membranes of the throat 
are affected, the contagious ; 3d, of that without spots ; 4th, 
of the malignant. 

Every kind of scarlet fever may be divided into three 
stages : the first is that of the eruption, the second, that of 
maturation; and the third, that of the desquamation or 
scaling. The period of the stages has been stated as twenty- 
one days, when the malady runs its regular course. This 
period has been shortened from five to eight days, by the 
hydropathic treatment. 

The treatment of scarlet fever depends greatly upon the 
momentary condition of the patient, and should be modified 
by his individuality, his constitution, and the stage to which 
the disease has advanced. 

Generally a moderate diet, proper temperature, and wash- 
ing with luke-warm water of 14° to 24° Reaumur (63£° 
to 86° Fahrenheit), will suffice to overcome the scarlet 
fever in a few days. Yet, when the fever is high, the tem- 
perature of the skin increased, when the eruptions seems 
disposed to recede, we sometimes have recourse to wrapping 
the patient in wet sheets, which must be changed as often 
as they become dry. 

Generally, the eruption reappears already at the third or 
fourth envelopment, after which it is only necessary to re- 
new the ablutions. 

When there is congestion of blood to the head, cold wet 
cloths or ice caps should be used as fomentations on the 
head, the former should also be applied when there is sore 
throat. 

To facilitate the diagnosis of this complaint, and to make 
the treatment more comprehensible, I shall add here the 
history of several cases, with different terminations. 



SCARLET FEVER. 215 

SCARLET FEVER OF A MILD AND REGULAR FORM. 

Amelia, a girl of three years of age, of weakly constitu- 
tion, fair hair, blue eyes, a very fine skin, after having been 
weak, cross, and without any appetite for several days, was 
suddenly attacked by a violent fever, beginning with chills ; 
then heat, during which she vomited several times, and 
became hoarse. 

When I had called to see the child, she was in a fever 
heat, her voice was hoarse, she had frequent thirst, and 
pains, when swallowing. From these symptoms, and the 
knowledge that the disease prevailed in that part of the 
country, in the form of an epidemic, I concluded that it 
would soon break out here. As by degrees, the child be- 
came more uneasy, as the stupor of the head and the heat 
of the body continued to augment, and towards midnight, 
the skin continuing dry, delirium occurred, I had her wrap- 
ped in a single sheet, which had been dipped in hydrant 
water of 8° Reaumur (50° Fahrenheit), not wrung too 
much, and had it renewed as often as it dried up ; on the 
head and neck I applied fomentations with dry coverings, 
which were renewed frequently ; and from time to time, I 
gave her cold water to drink. After having been enveloped 
five times, that is after about six hours, the child fell into a 
quiet sleep, from which she awoke the next day, at ten 
o'clock, A. M., dripping with perspiration, when, with in- 
creased expectoration, the scarlet eruption appeared, first on 
the neck and breast, and by six o'clock in the evening had 
spread over the whole body. During this time, whenever 
the skin began to get dry, I had her washed in the bed with 
water of 20° Reaumur (77° Fahrenheit) and had her well 
covered every time. These ablutions we had to perform 



216 SCARLET FEVER. 

four times, in thirty-six-hours. As soon as the eruption 
had partly come out, I continued the fomentations round the 
head and neck for thirty-six hours longer, allowed a very 
moderate quantity of water to be drunk, and had the patient 
washed twice a day with water of the above temperature. 
After two days the scarlatina commenced to subside, when 
I ordered a bath of 18° Reaumur (72J Fahrenheit), for 
five minutes, in consequence of which the desquamation pro- 
ceeded rapidly and easily. 

On the fifth day, the child was running about in the room 
quite well, and in good spirits, and on the seventh it was 
taken out into the fresh air ; this was in the month of May. 

SCARLATINA WITH RECESSION AND AFFECTION OF THE 
BRAIN. 

Louisa Banath, was child's maid with the little girl, during 
that sickness, of which we have just related the history ; 
was eighteen years of age, strong, well formed, lusty, of a 
good figure ; she had fair hair, blue eyes and a fine delicate 
skin. 

Already, during the last few days, that she attended upon 
the sick child, she suffered from the usual premonitory symp- 
toms of scarlet, but on account of the sickness of the child, 
she concealed her indisposition from her employers, until the 
morning of the 28th May, when she was no longer able to 
get out of bed. When I visited the child in the morning, I 
was requested to see the child's maid in the nursery. 

I found the patient in great heat, with stupor of the head, 
her look piercing, her voice hoarse, swallowing very diffi- 
cult, the cheeks very red, breathing rapid and short, the 
skin dry and hot, the pulse full, hard and accelerated, whilst 
she complained of buzzing in the ears, &c. 



SCARLET FEVER. 217 

To reduce the heat of the body and to induce perspiration, 
and by this means to bring the eruption to the surface, I 
ordered, as in the former and all similar cases, cold fomenta- 
tions round the head and throat, the latter with dry cover- 
ings, enveloping the whole body in a single coarse linen 
sheet, which had been dipped into cold water, and had not 
been wrung too much. This was changed every two hours? 
and when necessary, more frequently, whilst the patient 
drank plenty of water. 

After eight hours, that is, after the fourth enveloping, a 
copious perspiration appeared. Towards six o'clock the 
eruption was discovered in the face, on the neck and breast, 
and after ten o'clock, when I left the patient for the last 
time that day, the efflorence was fairly out all over the body. 

When I was going away, I directed the nurse, a weakly 
old woman, who had been sent for in the morning, to renew 
the fomentations on the head and neck frequently, to give 
the patient to drink, and in case dry heat should occur or 
she should become restless, to wash her quickly with tepid 
water of 15° Reaumur (65|° Fahrenheit), for which pur- 
pose, I left her the Thermometer ; to cover her lightly, but 
well, and in case delirium or other suspicious circumstances 
should appear, to send for me immediately. 

The next morning, the 29th May, I drove early, at 
five o'clock, to a patient, who lived at some distance, and 
did not return until seven ; when I learned that I had been 
sent for, several times, from the same house, as the child's 
maid had got so much worse, that she was not expected to live. 

Immediately on entering the sick-chamber, I perceived, 
at the first glance, that in consequence of taking cold the 
efflorence, which had but just appeared, but had been very 
vivid, had receded, and had fallen upon the brain of the 
patient, and that in consequence paralysis of the brain 

19 



218 SCARLET FEVER. 

was to be feared, for the patient lay stretched out on her 
bed unconscious, her complexion as white as chalk, the eyes 
fixed and turned upwards towards the ceiling ; her breath 
was hot, the lips and tongue dry and chapt, the respiration 
much oppressed, and performed with the motion of the ab- 
dominal muscles and the wings of the nose, on the forehead 
and the lower part of the thighs, cold perspiration, the feet 
cold, but the rest of the body very hot, the patient mumb- 
ling to herself unintelligibly, sometimes tossing about her 
arms, putting her hands to her head or playing with the 
coverlid. 

Perceiving the danger, I took no time to make inquiries, 
but immediately sent for a large bath-tub, which I had filled 
with cold hydrant-water, for a couple of pitchers of cold 
water, dry sheets, a blanket, and several pieces of bedding, 
which I told them to keep in readiness. 

As soon as all these things had been brought, the patient 
was taken by two strong women, who laid hold of the four 
corners of the sheet, on which she lay, and dipped her three 
times, as quick as possible, up to the chin into the water. 
At every immersion, affusions were made over the head, at 
which the patient screamed aloud. After this she was 
placed upon a dry sheet, well rubbed until perfectly dry, and 
once more immersed, very rapidly, in the water ; she was 
then wrapped in a dry sheet, her neck and head enveloped 
with cold fomentations, she was well covered, and left thus, 
until the heat of the body returned, when this had taken 
place, the above proceeding was repeated. Already at the 
first time the progress of the threatening malady was arrest- 
ed ; by the second, evident improvement with momentary re- 
turn of consciousness was effected ; and by the third, the 
patient was restored to full consciousness, in a period of two 
hours. 



SCARLET FEVER. 219 

Now she was put into bed, dripping wet, and well cover- 
ed. Towards eleven o'clock the perspiration broke out ; 
the eruption appeared again, and at two o'clock, P. M., 
covered the body as finely as before. The patient then fell 
into a quiet sleep, from which she awoke towards five in the 
evening, and felt quite comfortable, with the exception of 
a little weakness, and heaviness of the head. During the 
above treatment, I learned that the patient had fallen asleep 
after twelve o'clock, that the sick-nurse had felt too hot, 
and that in consequence she had opened the door a little, 
after which she had felt weak and very sleepy, and had, as 
the patient was sleeping quietly, not hesitated to lean her 
head upon the pillow of the sick woman. In this position 
she had fallen asleep, about two o'clock, A. M., and had 
not awaked until half-past five o'clock, in the morning. 
Finding the sick-bed empty, she had become alarmed, and 
on seeing the patient, who was lying unconscious, on a 
chair, near the open window, she had involuntarily screamed 
aloud, at which the other servants of the house had come in, 
and had called the master and mistress of the house, who 
had immediately sent for me, and not finding me at home, 
had had the unconscious patient placed upon the bed, and 
had left her there. From the patient herself, I learned, that 
she had waked up in a great heat, and with violent head- 
ache, and having been befallen by uncommon terror, seeing 
the nurse asleep, she had yielded to her desire for fresh air, 
had stolen to the window, had opened it and looked out, 
until attacked by giddiness and sickness of the stomach, she 
had wished to retire from the window, but had sunk down 
unconscious in the attempt. 

By remaining for some time after two o'clock, during a 
night in May, with the door and window open, whilst the 
effiorence of scarlatina was on her, the draught had given 



220 SCARLET FEVER. 

her such a cold, that it had receded, and had attacked the 
brain, in which, if not a considerable, at least a small and 
partial effusion (exudation) had taken place. 

On account of the obstinacy of the disease, the immer- 
sions had to be repeated three times. 

The efflorence of the scarlet, which had re-appeared, 
lasted three days, after which the redness subsided gradually, 
and the desquamation commenced. During the former I 
ordered ablutions of 12° Reaumur (59° Fahrenheit), and 
during the time of desquamation, daily a full bath of 15° 
Reaumur (65|° Fahrenheit), and on the ninth day, had the 
pleasure of meeting the patient in good health in the garden. 

At the time of the scarlet epidemic, which visited Klos- 
terneuburg in Lower Austria, and since 1841, since which 
time I have resided in the United States, I have applied the 
above treatment with upw r ards of a hundred children, more 
or less modified according to circumstances. Of all these 
patients, I have lost but one child of eight months old, in a 
family in New York ; and who knows, if this one had died, 
if the over-anxious mother had followed my directions in 
my absence, and had not yielded to the advice of the pre- 
judiced nurse. But instead of applying the cold ablutions 
of 8° Reaumur (50° Fahrenheit), which I had ordered every 
two hours, during the fever heat, until perspiration should 
ensue, the mother, afraid for her delicate little girl, used the 
warm baths (I do not know of what degree), which the 
nurse had recommended. 

When formerly I treated the disease in a different way, I 
have lost sometimes more than half my patients. 



SELF-POLLUTION. 

Is a vice, which unfortunately is not unfrequently found 
both in boys and in girls ; it enervates the body, destroys 
the capacities of the mind, and becomes the source of nume- 
rous maladies and sickness in after years. 

The causes of this vice are, bad examples, immoral lan- 
guage, associating with badly brought up children, the 
wearing of too tight pantaloons, swinging or rocking, early 
riding on horseback, sitting cross-legged, &c. 

The symptoms of the existence of this vice in either boy 
or girl, are : spots on the linen and bed clothes, blue rings 
around the eyes, sudden, pale color and emaciation of the 
body, the tottering uncertain walk, the dull dim look of the 
eye, frequent inclination to sleep, sudden fatigue, starting at 
trifles, trembling of the limbs, inclination to be alone, and 
with girls, when they sit cross-legged. 

As soon as parents perceive that their child is given to 
this vice, or if they only have reasonable suspicion of it, 
they should immediately see, that his or her associates are 
changed, and that all existing causes are removed. The 
child should frequently be bathed, should take daily from 
three to four hip-baths, but if nothing will avail, some ma- 
chine ought to be worn. 



TYMPANY OR WIND-DROPSY. 

A disease which resembles wind or flatulent cholic in 
children, which arises either from the generation of a pecu- 
liar gas, from weakness in the intestines, or in consequence 

19* 221 



222 OVER-FEEDING OF CHILDREN. 

of some other existing sickness, such as typhus, &c. In 
tympany, arising from some preceding or present sickness, 
the treatment should be regulated according to the character 
of that disease. 

Tympany, which is not consequent upon some other dis- 
ease, arises from weakness in the alimentary canal itself, 
generating a peculiar air, composed principally of carbonic 
acid and hydrogen gas, and forming a separate malady, 
which is fostered by a certain diet, such as fermented, windy, 
sour or over-sweet articles of food. This evil is easily re- 
cognized by the drum-like, much distended abdomen, which, 
when we tap upon it, sends forth a clear sound, without any 
rumbling, or pain, which distinguishes it from flatulent colic. 
It further differs from other complaints, principally from 
typhoid diseases, that the abdomen is not, as if divided, by 
a band in two halves, about the region of the navel, but 
that in Tympany it appears like one whole. 

A regular diet, avoiding all windy articles of food and 
drink, washing the whole body, half-baths, frequently 
during the day wrapping the abdomen in wet cloths, four to 
eight cold injections, and repeated drinking of water, will 
soon remedy the evil and restore the patient to lasting 
health. 



OVER-FEEDING OF CHILDREN. 

This takes place, when the feeding by hand is not per- 
formed with that patience, circumspection, and proper choice 
of the articles of food, which the delicate organs of the chil- 
dren require. Generally this important business is entrusted 
to cross, unreflecting, young or old hired persons, who, 
although the child resists, cries, and screams, and kicks 



WATER IN THE HEAD. 223 

with hands and feet, stuff the whole quantity which is in- 
tended for the child, at once down its throat. By so inju- 
dicious a feeding, the stomach is filled to such a degree, 
that it cannot digest, from one meal to the other, the quan- 
tity which it receives, causing repletion in the upper part 
of the alimentary canal, and giving rise to the following 
disease, which frequently becomes dangerous or tedious. 

The child is peevish, much inclined to cry, shows no par- 
ticular inclination to eat, frequently vomits after meals, the 
stool is indolent, it becomes bloated in the face, and the ab- 
domen increases in size. 

When the complaint has advanced to this point, it is time 
to make an alteration in the food and the manner of feeding 
the child, which ought to be such, as was pointed out 
under that head. Let food be given to the child only at 
fixed periods, and never more, than it will receive without 
resistance. 

At the same time we should not neglect to bathe it a 
couple of times a day ; when there is costiveness,to give in- 
jections ; and when the lower part of the abdomen appears 
already distended, to make fomentations in front, which 
must be renewed whenever they begin to dry up. In this 
manner we shall not only check the progress of the evil, but 
the child will regain its former health. 



WATER IN THE HEAD, (hydrocephalus.) 

Most physicians divide this disease into the internal 
and external, the acute and the chronic, and adopt 
four varieties with the former, according to the seat of the 
complaint. It is congenital or constitutional with the child : 
the congenital being again divided into that which is devel- 



224 WATER IN THE HEAD. 

oped at the birth of the child, and that where there is only- 
inherited predisposition, which manifests itself later. 

The voluminous angular form of the head, that of the 
fontanelles, the stupidity or imbicility of the child, are com- 
mon characteristic symptoms, which announce the internal 
hydrocephalus. Besides these, there is in the beginning a 
disposition to vomit, to constant sleep, giddiness, pain and 
heaviness in the head. Notwithstanding the general emaci- 
tion of the body, the appetite increases, the walk becomes 
more uncertain and staggering, the senses more blunted, the 
faculty of vision decreases, the child is attacked by convul- 
sions, the speech becomes inarticulate, the evaporation from 
the skin as well as the secretions and separations, with the 
exception of that of the saliva, are suppressed and inter- 
rupted. 

These morbid symptoms which gradually increase, but 
too often, lead to entire imbecility, blindness, deafness and 
dumbness, whilst the extremities become cold, and the exis- 
tence of the child is terminated by apoplexy. 

Pure fresh air, simple nutritive food, and drinking plenty 
of water, staying in the open air, and plenty of exercise out 
of doors, daily perspirations in wet sheets, and subsequent 
cold ablutions, then baths, affusions over the head, fomenta- 
tions over the same, and wearing of the ice-cap, I have 
found particularly efficacious. 

Respecting the external hydrocephalus, we understand by 
it a larger or smaller tumor, which appears upon the exter- 
nal surface of the head, sometimes from a morbid state of 
the constitution, which is formed by a serous or lymphatic 
accumulation, between the membranes of the brain and the 
bones of the skull. This complaint is divided into partial 
and complete, the first generally occupies only a small por- 
tion of the head, and appears as a round, circumscribed tu- 



WATER IN THE HEAD. 225 

mor, whilst the complete external hydrocephalus occupies, 
not only the entire hairy scalp, but also, frequently the neck 
and the forehead. The latter, according to its exudation, 
is also divided into the cellular, the aponeurotic and perios- 
tic external hydrocephalus. The division however has no 
essential influence upon the treatment of the disease. The 
external hydrocephalus is distinguished from the internal, 
when on pressing with the fingers, we distinctly feel the 
bones at the bottom of the tumor, if it is not connected with 
the internal one by some fontanelle or suture. If at the 
same time the sick child is free in its motions, if, when 
screaming, it can breathe freely, if by a quick motion, such as 
rocking or dancing, it does not become stunned, it is a pure 
external hydrocephalus. Hydrocephalus, particularly the 
external local, may be mistaken for the rupture of the brain 
swelling of the brain and the watery rupture of the brain, 
if we do not pay attention to the following characteristic 
symptoms. 

The child which is afflicted with rupture of the brain, 
swelling of the brain and watery rupture of the brain, cries 
very seldom, only loses its breath in severe cold, or when 
the head is bent forward, but not from any other irritation. 
When the bending forward is done very rapidly, it becomes 
alarmed, and death sometimes is the consequence. Every 
pressure, applied to the tumor, causes convulsive paroxisms, 
and, like the sudden bending forward, may prove fatal. 



WORM-DISEASE. 

Is a disease, which occupies the attention of physicians 
to a great extent, as scarcely an individual remains free 
from its effect during the age of childhood. It arises from 
the morbid disturbance in the alimentary canal and the for- 
mation of several kinds of worms, consequent thereupon. 

The different inhabitants of the alimentary canal, are di- 
vided into four species, namely ; the ascaris lumbricoides ; 
(the large round worm) the ascaris vermicularis, among 
which we also reckon the oxyurus vermicularis (the maw or 
thread worm); the trichocephalus (the long thread-worm), 
and the taenia, (the tape- worm), which by some is again 
divided into the taenia solium (the long tape-worm) and the 
taenia lata (the broad tape- worm). The treatment of the 
tape-worm has already been fully discussed. 

The Ascaris Lumbricoides has a round body, from six to 
fifteen inches in length, and from two to three lines in diam- 
eter, not unlike a quill, and much like the earth-worm, it is 
of an opaque, pink color, and gets thinner at both ends, less 
at the tail-end, than towards the head. At the head, there 
is an indentation, on which there are three valves. The 
body appears grooved on both sides. Their common abode 
is in the small intestines, although they have often been found 
in the stomach and the oesophagus. 

The oscaris vermicularis, which are also called thread- 
worms, from the resemblance to bits or ends of thread, are 
very quick in their motion, are found in the colon, the rec- 
tum, and are the tormenting companions of children. This 
worm is from one and a half to five lines in length, the head 
is blunt, puffed, and perforated by a tube, and the tail ter- 
minates so gradually that the point is scarcely perceptible. 



WORM DISEASE. 227 

The cause of worms, is constitutional or acquired weak- 
ness of the alimentary canal, bad, indigestible food, damp 
dwellings, and bad air, producing disproportion between the 
power of assimilation of the digestive organs, and the food 
introduced. In consequence of this, part of the food remains 
behind in the folds of the intestines, ferments there, and thus 
generates worms, or midges, which after they come to per- 
fection propagate their species by laying eggs. 

The phenomena, presented by the derangement in the 
alimentary canal, differ much according to the kind, condi- 
tion, number and seat of the worms ; the following symp- 
toms, however, will justify the conclusion that worms exist 
in the intestines : 

Bloated, leaden colored countenance, dull eyes, and en- 
larged pupilla, and blue rings round the eye. Itching in 
the nose, much sneezing, lost appetite, bad breath, nausea 
of the stomach, inclination to vomit, real retching, much 
discharge of saliva, a truly morbid appetite, gnashing with 
the teeth, spasms, convulsive paroxysms, trembling, whey- 
like urine, itching at the rectum, &c. 

A regular nourishing diet, pure air, and much exercise 
out of doors, frequent washing, bathing, affusions, wearing 
of wet fomentations around the lower part of the abdomen, 
half and whole injections, and frequent drinking of cold 
spring and hydrant water, in the same manner as used for 
the tape- worm, always produce the best effect. 



WOUNDS. 

These are divided into thrust, cut, and shot wounds, 
wounds from a bite and contusions, which again are subdi- 
vided according to the instruments, with which they have 
been inflicted, the depth, to which they have penetrated, 
and the part of the body which has been injured. When 
the separation of the parts is such, that it is necessary to 
bring them together by a bloody suture or some other tech- 
nical operation ; when one of the more important parts is 
injured, when an artery or a sinew, &c, has been severed, 
when balls, shot, parts of the clothing or other foreign bodies 
are in the wounds, surgical assistance should be immediately 
procured. 

But, until this assistance can be obtained, the wounded 
part should be placed in a vessel filled with cold, if possible, 
ice-water ; this water should be changed as soon as it begins 
to get luke-warm, or mixed with much blood. In this water 
the limb should remain, until the bleeding is stanched. If 
however, the injured part cannot well be got into a vessel 
with cold water, then cold fomentations, with cloths, four or 
eight fold, should be applied, which must be wrung but very 
slightly, must remain without dry coverings, and be ex- 
changed, at least, once every ten or fifteen minutes for fresh 
ones, which are to be kept in readiness. 

When the bleeding is violent, and caused by an injury, 
of one of the arterial vessels, by which the person is in dan- 
ger of bleeding to death, or of being severely injured, before 
a physician can arrive, we should not hesitate to interfere, 
by compressing the wound firmly with the hand, the thumb, 
or an instrument, for instance, the key of a door, round the 

228 



wounds. 229 

handle of which, some linen has been wrapped, and which is 
pressed tightly, one or two inches, above the wound, until 
assistance arrives. If this can be done w T ith the thumb or 
some other finger, it should be applied on the very spot, 
from, which the blood escapes. 

If the dangerous bleeding is from an artery, either of the 
upper or lower limbs, for instance, the femoral artery, and 
we cannot stop it in the manner described above, we then 
take a diapered bandage, one and a half to two inches in 
breadth, place it loosely three or four fingers' breadth above 
the wound, around the hand or the foot, and on the spot 
under which the blood-vessel is flowing, we place inside of 
the bandage a pad, folded together several times, and on the 
opposite of the knot which ties the bandage, we introduce a 
solid stick, and twist it round its axis until the bleeding 
stops. We now hold it in that position until surgical aid 
arrives. 

When the injury is too near the end of the vessel, as, for 
instance, at the upper brachial artery, at its exit from the 
axilla (arm-pit), or at the axillary artery itself, the pressure 
should be applied in the before described manner, above and 
behind the collar-bone. When the injury is high up on the 
femoral artery, the pressure is to be applied to the middle of 
the os pubis. 

When the bleeding has been arrested, the foreign bodies 
have been removed from the w T ound, and the edges of the 
wound have been brought together, the part should be 
washed clean, and the patient be brought to bed, with the 
injured limb, in a proper position. Over the wounded part, 
a single linen rag, which has been steeped in cold water, is 
placed, and over this the above described fomentations, 
rather more wrung, to be changed as soon as they lose their 
coolness, which will take place at least every fifteen to 

20 



230 WOUNDS. 

twenty minutes. If the inflammation, that is to say, the 
pain, the heat, the redness, and the swelling diminish, let 
the fomentations be gradually wrung more, and be applied 
less often ; if a pricking and itching takes the place of the 
pain, let the fomentations remain upon it, until they begin 
to dry up. In those cases, in which suppuration takes place, 
particularly with wounds caused by a shot or a bite, as soon 
as the inflammation terminates in suppuration, substitute 
tepid fomentations of 15° to 18° Reaumur (65|° to 72|° 
Fahrenheit), for cold ones, and change them likewise as soon 
as they begin to dry up, which treatment, together with a re- 
gular diet, must be persevered in until perfect cicatrization 
and reduction of the swelling. 

This treatment, which I have used during twenty-two 
years of practice, as well in hospitals as in private families, 
with numerous wounds of all kinds, and even with amputa- 
tions, has convinced, both me and hundreds of persons, who 
have been healed, that not only wounds of every kind, can 
be healed quickest without salves, plasters, balsam or other 
medicaments, by the sole application of water, but also that 
this method of healing, leaves behind the least perceptible 
scars. # By the treatment with water, all excessive suppu- 
ration, caries, mortification, and paroxysms of fever are pre- 
vented, and the strength of the patient sustained sufficiently 
to keep up the reaction, by making the wounded person, ac- 
cording to the degree of the existing fever and inflammation, 
take half or whole baths, every day wash once or several 



* I cannot refrain here, from expressing a wish, that the treasury, as 
well ,as the administrators of civil hospitals, would convince them, 
selves, that all sorts of wounds heal quicker, better, and more beautifully 
without any medicine. How much money would be saved in this man- 
ner, particularly in time of war, which might be applied to other benev- 
olent objects. 



CHAFING OF INFANTS. 231 

times the whole body, or having him wrapped up in wet 
sheets, whilst he drinks cold water, and when constipation 
occurs, giving injections. 



THE CHAFING OF INFANTS, (inter-trigo.) 

A complaint which occurs particularly, with fat, well- 
nursed children, which degenerates as often as it can be the 
effect of internal acrimony of the infant, of bad milk of the 
mother, of bad food, of damp dwellings and uncleanliness. 
The chafing appears most commonly on the two inner sides 
of the thighs, of the private parts ; also in the creases of the 
breech, on the knee joint, and even under the arms, at the 
elbow joints, behind the ears, under the chin, and in the 
creases of the neck ; and by its itching, annoys the child ex- 
cessively, preventing it from sleeping. The child consequent- 
ly gets really sick, cries incessantly, and is always uneasy. 
Chafing does not unfrequently degenerate by its spreading, 
and by pustules forming round its exterior margin. These 
exude a purulent fluid, and dry up to a crust, under which 
matter collects, which becomes the cause of ulcers. 

Frequent bathing of the child, at least once or twice a day, 
in tepid water of 20° to 22° Reaumur (77° to 81|° Fahren- 
heit), frequent washing of the sore parts with bran-water or 
milk, and when the chafing is not very extensive, a moder- 
ate application of hair powder, will be of use. In cases, 
where the excoriation of the skin has already taken place, 
where the parts are inflamed, and the skin is tense, sweet 
cream should be used instead of powder, and the sore part 
be covered with it, over which a single fine rag, which has 
before been dipped in fresh water is put, which, whilst the 
washing and the baths are continued is repeated as often as 



232 THE WHITES. 

the rags become dry. In this manner the chafed parts wil 
soon heal, if otherwise the milk of the mother or the food of 
the child is good, and if it breathes a wholesome air, and 
the tortures of the child will terminate rapidly and safely. 



THE WHITES, (fluor-albus.) 

By the general appellation of the whites, we understand 
every increased abnormal secretion of mucus from the vagina 
and the womb, of the mucus membrane of the external parti 
of generation, and of the urethra. 

Respecting the classification of the disease, which differs 
according to the quantity and quality of the discharge, to 
its cause and course, I shall reserve further details for th 
proper place, and mention here only those kinds, which 
occur most commonly before or during the puberty of the 
female, these are : that which arises from mechanical irrita- 
tion, self-indulgence or worms ; secondly, that, arising from 
constitutional or adynamic causes, for instance , from inher- 
ited, congenital or acquired diseases, such as scrofula, rick- 
ets, syphilis ; thirdly, after scarlet, miliary, catarrh and 
rheumatic fevers, gout, &c, and fourthly, that, from sup- 
pressed menstruation, at the commencement of puberty. It 
occurs most frequently after the commencement of purberty, 
and mostly with women,* but it has also been observed at 
every age, before the commencement of the menses,and even 
with new-born infants. 

The discharge, which has arisen from mechanical irrita- 
tion, and from consequent evacuation, and after scarlet-fever, 
is always of an innoxious character, and when the cause, for 

* More of this in my Botanical practice. 



THE WHITES. 



233 



instance, the mechanical irritation, &c,is removed, under a 
well regulated diet and by proper conduct, disappears very 
rapidly. But with weakly persons and under improper 
treatment it may easily degenerate into a cronic malignant 
discharge. On the contrary, the fluor albus, the cause of 
which lies in some inherited, congenital or acquired disease, 
as well as that, which arises from the non-appearance of the 
menstruation, always indicates a habitual weakness, the 
suppression of which, requires a longer time, as we have not 
only to do with the mucous discharge, but in the former 
cases, with the removal of the primary morbid cause. Where 
the non-appearance of the menses, is the source of the evil, 
the first cause is a bad preparation of the blood and conse- 
quent indolence in the circulation, particularly in the female 
genitals, as also an abnormal activity in the mucous vessels. 
It is therefore, above all things necessary, to increase the 
activity of the circulation in those parts, and thus to restore 
the equilibrium between it and the mucous vessels; when this 
succeeds, the appearance of the menses, will be the result, 
and the health of the patient will be restored. The conse- 
quences, which in the course of time may result from the 
neglect of a similar fluor albus, are: a pale, bloated look, 
weakness of digestion, hardness of the abdomen, when 
touched, particularly over the pubes, emaciation of the whole 
body, weakness of body and mind, diseases of the lungs, and 
the abdomen, hectic fever (wasting fever) and death. 

As to the treatment of the whites, this is generally and 
particularly to be regulated, according to the above described 
four principal varieties, at the same time, taking into con- 
sideration the age and bodily strength of the individual A 
regulated diet, constituted of simple food, of milk and fruit 
prepared without any spices, avoiding, all fat victuals and 
meat, a pure air, cleanliness of the body and its clothing, 

20* 



234 THE WHITES. 

much exercise, particularly climbing mountains, and fre- 
quently drinking hydrant- water form the principal features 
of the treatment. 

Instead of entering specially into the description of these 
different varieties, I take the liberty of giving here the his- 
tory of four cases to make it more intelligible to the layman. 

HISTORY OF A FLUOR ALBUS, PRODUCED BY MECHANICAL 
IRRITATION, THAT IS, BY SELF-POLLUTION. 

Julia N , eleven years of age, was, by the bad ex- 
ample of thoughtless, rather elder, companions, for want of 
proper education, led to commit self-indulgence ; the parents 
suspecting nothing, and only troubled at the looks of the 
child, which was growing worse, and the cause of which they 
attributed to chlorosis, at last asked my advice. 

I found the child a well grown, fair haired girl, of a very 
lively character, pale, her eyes sunk, and deep blue rings 
around them ; the eye was dull, the lips pale, the whole 
figure emaciated, and the lower part of the abdomen, above 
the lap, was tense ; the girl had a good appetite, was how- 
ever silent, occupied with herself, and generally sought soli- 
tude. Besides this, I could learn nothing from her, but that 
she often felt considerable pain when making water. 

I therefore requested the mother to observe her daughter, 
according to my directions, and learned in a few days, that 
the chemise and the sheet were covered with mucus, which, 
as she pretended, she had, of late, frequently discharged in- 
voluntarily. The mother had also observed that the daugh- 
ter was in the habit of crossing her legs and moving 
her feet to and fro, also that she rubbed her hands against 
the private parts. After this, the mother, at my request, 
examined the girl, and the external parts of the pudenda 



THE WHITES. 235 

were found inflamed, and surrounded with a glutinous 
mucus. 

The existence of leucorrhoea from the vagina, in conse- 
quence of irritation, could no longer be doubted, as the 
mother had caught her in the act, and as she had conse- 
quently confessed all. After this time, when the girl was 
more closely observed, it was found that particularly in the 
evening, much mucus was discharged from the vagina. 

The mother now forbid her associating with the same 
companions, did not lose sight of the girl, and even slept 
with her, not neglecting to explain to her the dreadful con- 
sequences of this vice. 

By the strict conduct of the mother, the self-pollution 
was prevented, the exciting cause of the frequent leucorrhoea 
removed, and the consequent chlorosis checked in its pro- 
gress. By this means, and by frequent exercise in the fresh 
air, an active life in the house, where, exercising her mus- 
cular power, the little girl did not find time to think of 
such abomination, as self-pollution ; further, by living upon 
nourishing, spiceless food, the avoiding of coffee, tea, and 
all spirituous liquors, by drinking frequently cold hydrant 
water, and by taking a salt water bath, four times a day, of 
18° Reaumur (72 J° Fahrenheit), and of fifteen minutes du- 
ration, during which the abdomen was rubbed, the discharge 
was soon checked, and with it disappeared the chlorosis, so 
that six weeks after, the little girl looked as well and as 
fresh as ever. 



236 THE WHITES. 



CHLOROSIS FROM SYPHILIS. 



One day, four years ago, a single woman came to me 
with tears and lamentations, and told me that she was dis- 
eased about the genitals. After examination, I found on 
the one side of the labia majora, and on the two labia 
minora (the nymphae), five venerial ulcers, together with a 
malignant leucorrhoea from the vagina ; which, as she said, 
she would not mind, if her child did not suffer in the same 
parts, a similar discharge taking place from the vagina of 
the child many times in twenty-four hours and that, in 
reality, she had come to ask my advice for the child. 

After this, I told her to show me the child, and found a 
little child, of scarcely six months old, very weak, bloated in 
the face, pale, with a large and hard abdomen ; the limbs 
emaciated, the skin like parchment ; the external parts of 
the pudenda, a bluish white, and covered with a mucus, 
resembling starch, which, where it was flowing down, had 
excoriated the thighs. 

After having submitted the mother to a severe treat- 
ment, I ordered the child to be weaned entirely, to be 
fed upon a nourishing milk and flour diet, to wear night 
and day damp fomentations, consisting of four-fold linen 
rags, which had been steeped in water of 21° Reaumur 
(79^° Fahrenheit), and had been well wrung out ; these 
were changed as often as they began to dry up. At 
the same time, pads, less thick, were placed upon tht 
privates and the sore parts of the thighs. Besides this 
the child, after having been well washed in water of 20 c 
Reaumur (77° Fahrenheit), was wrapped, dripping wet 3 
in dry, linen cloths, was covered with bed clothes, made to 
perspire, and afterwards placed in a bath of the same tern- 



THE WHITES. 237 

perature, after which it was dried, and the fomentations ap- 
plied. It was now wrapped up well in its bed, carried into 
the fresh air, it being summer, and very warm, and had fre- 
quently to drink cold water. 

After the expiration of twenty-four days, the discharge 
had disappeared, from which time forward, the looks of the 
child improved so much, that in the sixth week it was sound 
and well. 

CHLOROSIS AFTER SCARLET FEVER. 

A daughter of Joseph Kraft, fifteen years of age, was at- 
tacked by scarlet fever, when it was prevailing as an epi- 
demic. She got safely over the fever, in which I treated 
her, but during the period of its desquamation, I was 
obliged to leave home on family affairs, and did not see her 
again until a fortnight later, when her mother came to meet 
me, with the exclamation, that her daughter was very sick, 
as, besides being much swelled, she suffered at the same 
time from chlorosis and fluor albus. The otherwise bloom- 
ing girl, was as white as a sheet in the face, looked bloated, 
the lips and gums white, the abdomen considerably swollen, 
tense, and particularly hard towards the lower part ; the 
lower limbs, especially the feet, much swollen, the appetite 
lost, digestion very bad, the skin dry and yellowish, and 
feeling hot, principally towards evening, the stool watery, 
the urine very rare, sparing, and reddish ; at the same time 
a frequent discharge of a whey-like slimy fluid, from the 
vagina, which, several times a-day, was followed by small 
lumps of greater consistency and salty. 

According to all these symptoms, the cause of the whole 
sickness was here, a receding of the disease during the period 
of desquamation, throwing the morbid power upon the abdo- 



238 THE WHITES. 

men ; that is to say, upon the glandulary system, and sym- 
pathetically producing that discharge of mucus, from the 
genitals. 

After the patient had been rapidly washed in water of 
20° Reaumur (77° Fahrenheit), I had her well wrapped up 
twice a day, in a linen sheet, which had been steeped in 
water of 10° Reaumur (54|° Fahrenheit), and been well 
wrung, and allowed her to sweat in it : the first day, each 
time, half an hour, the second day a whole hour, and the 
third day two hours, after which, she was every time rubbed 
with water of 15° Reaumur (65| Q Fahrenheit), which be- 
sides this, had to be done to the feet twice a-day, when they 
were wrapped up dry and carefully. Over the belly a damp 
fomentation of pads, dipped in water of 10° Reaumur (54 J° 
Fahrenheit), was put, whilst the genitals were well washed, 
and the patient was obliged to drink much cold water. We 
did not forget to ventilate the room frequently, and for the 
first few days allowed the patient no other food but milk. 

Already after the fourth day, desquamation occurred, 
and in proportion as this advanced, the discharge decreased, 
wherefore on the fifth and sixth day of the treatment, 
let the patient sweat only twice a day, each time an hour ; 
on the seventh and eighth, only once, and on the ninth, al- 
lowed her to discontinue it altogether. Whilst her food 
was nutritious, she was obliged to walk a great deal about 
the room, and only the ablutions and fomentations were con- 
tinued ; on the twelfth day, the patient was allowed to put 
aside these also, and on the same day she went for the first 
time into the fresh air. From this time she was for the next 
eight days, every morning, immediately after rising, washed 
with water, out of which the chill had merely been taken, 
and rubbed with it. After which time the swelling and dis- 
charge disappeared, and the girl was in good health, which 
showed itself in the return of her wholesome color, 



DROPSY. 

Besides the dropsy in the head, of which we have already 
treated, we have dropsy of the spine, of the chest, of the 
pericardium (a membrane surrounding the heart), of the 
abdomen, the so-called ascites, of the womb, of the ovaria, 
and general dropsy (anasarca). 

Dropsy with children, in my opinion, may be congenital 
or inherited, in consequence of the morbid formation or 
changed condition of some organ, as for instance, the liver, 
spleen, mesenterium, or it may be acquired, which I have 
found, particularly after eruptions, such as scarlet and miliary 
fever, in which case, it was either abdominal or general 
dropsy. These latter cases were always safely cured, in the 
former cases, however, only temporary relief was obtained by 
appropriate diet, pure air, exercise and frequent wet friction, 
or washing of the whole body. 

The dropsy of the abdomen, which together with general 
dropsy, I have had most frequently opportunities of observ- 
ing in children, may in general be divided into chronic 
dropsy, consequent upon the morbid formation or change of 
some internal organ, and in the acute or rapidly progressing 
dropsy ; and as the latter is exactly the one, which occurs 
most commonly with children, and in which, when timely 
assistance is afforded, this treatment shows itself in brilliant 
colors, I cannot omit to speak of it here. 

239 



240 DROPSY. 



ABDOMINAL DROPSY. 

By this we understand several varieties of accumulation 
of water in the abdomen, in which the effused fluid, is free in 
the bag of the peritonaeum (the lining membrane of the ab- 
domen) and washes round the intestines, which it invests or 
contains. 

A second variety is that, when the water is enclosed by 
itself in smaller or larger bags or skins, called sacs, which 
are free in the cavity of the abdomen, or where these bags 
or skins by means of a long and narrow base, are seated in 
the parenchyma attached before, or to some one of the intes- 
tines, as the liver, &c, being the result of some former in- 
creased co-agulation of the organ, which in consequence of 
an acute state, had been overcharged with blood and lymph. 
The number of these bags, as well as their form and size 
differ. A similar but rarer variety of dropsy is that, in 
which the two layers of the peritonaeum seem to be separatee 
by a watery effusion, this, as well as the other is called hy- 
drodystis or encystec dropsy. Besides these two kinds, of 
which the first mostly occurs with children, there are many 
other varieties, the explanation of which, as they generallj 
occur only with adults, I reserve for a more appropriate 
place. 

The abdominal dropsy arises generally symptomaticallj 
from secondary causes, for instance, after intermittent fevers 
eruptions of the skin, liver-complaints, diseases of the spleen 
after inflammation of the walls of the abdomen and intestines 
When primary, it is mostly a symptomatic phenomenon, anc 
with grown people, often appears as a chronic disease, witl 
debilitated organs of digestion, and diminished vitality. 



DROPSY. 241 

This disease is always of easy recognition, as it manifests 
itself in a uniform extensive swelling of the abdomen, the 
characteristic of which, is, either a tense or elastic, soft, 
flabby swelling, which yields in every part to pressure, rises 
again when the finger or the hand is removed, and which 
can be plainly felt, by the undulating motion of the existing 
water, when, placing one hand against one side of the abdo- 
men, we beat with the other against the other side. 

General dropsy or dropsy of the skin, is a collection of a 
watery, serous, lymphatic fluid, existing over the whole ex- 
tent of the cellular tissue, under the external skin, as w T ell 
as between the muscles which penetrates even to the paren- 
chyma, and mostly arises from diseases of the heart, of the 
lungs and of the kidneys. But like the abdominal dropsy, 
it may arise from the bite of a serpent, and is therefore 
always a secondary disease, and in consequence of a checked 
impaired or deficient preparation of the blood, as, for in- 
stance, an interrupted return of the blood to the left half of 
the heart, &c. 

The more the accumulation of water in the body increases, 
the more the soft parts become relaxed, they become softer 
and shrink more and more ; digestion and strength, as well 
as the activity of all the functions of the body, diminish, the 
body becomes emaciated, the skin more liable to chap and 
colder, the tongue dry, the urine is discharged sparingly, 
with a peculiar amoniac smell, in the last stage it being 
covered with a skin, the colors of which are changing, the 
stool also becomes rare, and for the most part greenish or 
blackish, the functions of the body sink, until at last they 
cease entirely ; in ordinary cases the lungs become paraly- 
zed and the patient dies. 

As to the treatment of chronic dropsy, it has already been 

21 



242 DROPSY. 

stated, how it should be commenced, and that it can never 
act otherwise, than palliatively. 

As to dropsy, arising from suppressed or scanty menstru- 
ation or in consequence of the bite of a serpent, the treat- 
ment described in the last history of disease, may serve for 
the former, and that under the head of " bite of a serpent' 
for the latter. Of the treatment of dropsy, in consequence 
of suppressed desquamation in the third period of the scarlet 
fever, a complete description is to be found in the history of 
the third case of scarlet fever. 

As well generally, as particularly, the manner of treatment 
must always tend, if we cannot increase the strength of the 
patient, at least to sustain it, to augment the activity of the 
skin, and by means of perspiration, or of frequent voiding of 
urine, to bring on a crisis, which, by the discharge of the 
morbidly effused fluid, from the organs affected, leaves 
these latter in such a state as generally to become again en- 
abled to execute uninterruptedly the separate functions 
which nature has imposed upon them, and together with the 
gradually increasing vital energy, expel this very produc- 
tion from the body, and thus to restore it again to health. 
Here we should first consider the strength of the individual, 
and regulate the diet accordingly, namely, simple, natural 
and nutritive. Good milk, not too rich, some wheaten 
bread, good soup with rice, sago and the like, roasted or 
stewed meat, particularly game, when given in small quan- 
tities at a time, several times a day, together with a suffi- 
cient quantity of cold water, a healthy, pure air and appro- 
priate temperature from 10° to 16° Reaumur (54J to 68° 
Fahrenheit), seldom fail to effect this object, especially 
when the nature of the patient is properly assisted by 
perspiring in wet linen sheets, preceded by dry friction of 
the whole body, with flannel or hair-gloves, during several 



THE BITE OF A SERPENT. 243 

minutes ; after the perspiration, again rubbing, first with a 
wet sheet around the whole body, and then friction with 
dry cloths, until the whole surface of the body has become 
red. According to circumstances this should be repeated 
once or twice a day, the duration of the application always 
depending upon the progress which the malady has made, 
and upon the strength of the patient. 

THE BITE OF A SERPENT. 

On the 10th of July 1840, the only child of Mrs. Josepha 
Mink, store-keeper, in Neustadt, a boy of thirteen years of 
age, when picking strawberries in a forest, was bitten by an 
adder, and afterwards found unconscious in a ditch by some 
person. His mother was notified of this, who did not hesi- 
tate to bring him to me to the Institution. They said, that 
two hours had elapsed since the bite had been inflicted. 

The boy looked very pale and suffering, his limbs hang- 
ing relaxed, with constant inclination to vomit, and real 
vomiting of a fluid resembling water, falling every moment 
into a state of unconsciousness. 

I found the right foot wounded, by a double bite below 
the ancle, and on the first joint of the toe, and the foot 
swelled cedematously, already a hand-breadth over the artic- 
ulation of the heel. 

I immediately ordered a foot-bath to be made for the 
patient over the ancles, in which each of the parts bitten 
were scarified, as many as sixteen times, and after the scar- 
ification he was obliged to remain in the water half an hour 
longer, whilst it was changed every two minutes. After 
the wounded part had been covered by a fomenting cloth, and 
the leg, up to the knee, enveloped in wet cloths, the patient 
was put to bed 



244 DIFFICULT TEETHING. 

Both the fomentation and the enveloping were changed 
every quarter of an hour, and the foot-bath repeated every 
two hours, whilst the boy was obliged to drink as much 
water as he could swallow : 

After a very uneasy night, in which the patient wandered 
much, and frequently vomited pure water, the whole leg, 
up to the hip, appeared much swelled. I now prescribed 
that the child should sweat twice a day, each time two 
hours, whilst the whole limb was wrapped up in wet rags, 
that all, that had been ordered before, should be continued, 
and that after the sweating, the boy should wash in cold 
water. Although on the third day after the bite, the swel- 
ling had considerably abated, the vomiting had ceased, and 
the boy was well, I continued, notwithstanding, all the 
applications until the fifth day, and on the sixth day, the 
16th July, I had the pleasure of seeing him walk about as 
well as ever. 



DIFFICULT TEETHING. 

Many authors have written on the subject of difficult 
teething, frequently contradicting each other directly, as to 
the development and the cause of the accompanying dis- 
eases, and in direct opposition with the laws of physiology 
and of nature, respecting their aetiology and exciting cause.* 

Difficult teething, properly speaking is no disease, but a 

* The reader may compare the writings of Calenis Coment 1519. 
Wichmann's 2d Vol ; Blumenthal on the ^Etiology of teething, 1 vol. 
Boerhave, Aphor. Jardain 2 Vol. 5. 544. Burdet 2d Vol. § 10. P. 35. Ber- 
lin 2 Part. § 159. VanSwieten in several treatises. Armstrong, translated 
bySchcefFer; SchcefFer's, diseases of Children, Bell, 2d Vol. § 159. Starks 
2d. Vol. Harvis on acute diseases of childern. — P. 34. Bernstein's 
Manual, 1 Vol. Henke's diseases of Childern, 5 Vol. 225. Hufeland and 
others. 



DIFFICULT TEETHING. 245 

natural process,* and an all-wise Providence has placed no 
more obstacles in the way of its development, than in that 
of any other, belonging to the human body, but on the con«- 
trary, has made provisions for the formation of the teeth to 
be gradual, without the necessity of any excessive effort, at 
the expense of the health of the child. The more or less in- 
creased activity or irritability depends entirely upon the 
state of the health, upon the strength, disposition to disease, 
condition in life, milk of the mother, &c, and can no more 
be attributed to the teeth themselves, than to the phenomena 
of the diseases which frequently appear at the same time, but 
which have no connection with the teeth whatever. They 
are of the same duration as dentition, but occur frequently, 
as we see every day, independently of this process, and per- 
haps more frequently. Dentition takes place in the country, 
but particularly in mountainous parts, where the inhabitants 
are still strangers to effeminancy, and where nature still 
appears in her simple garb, without any morbid phenomena, 
frequently, without being perceived by parents or attendants 
until the first tooth has been cut. 

We cannot therefore possibly attribute the after-mentioned 
phenomena, and forms of sickness to the cutting of the 
teeth, as there is setiologically and physiologically no con- 
nection between them, as every one of these after-diseases 
are in direct contradiction to the anatomical construction of 
the sockets, and gums of the teeth, at the age of infancy, 
and as no constant morbid phenomena are perceptible on 
any of the parts which come in immediate contact with den- 
tition. Should we, for instance, during this period, explain 
the redness or swelling of the gums, as a morbid phenome- 

* Vide Wichmann's Diagnostic 2. Vol. and Sternberg's doubts as to 
the difficult teething of Children, 1 Vol. Hippocrates Aphorisms, Sec. 
iii. P. 25, Celsus ii. Vol. P. 46 : Mercurialis P. 312, Kuster P. 417. 

21* 



246 DIFFICULT TEETHING. 

non ? By no means ; for is it not a natural consequence, 
that as soon as the crown of the tooth protrudes more or 
less, out of the socket, and approaches nearer to the gum, 
which covers it, that the latter should rise, increase in bulk, 
and also project over the still empty spaces over the sockets 
in the jaw? Nor can the redness, which appears in that 
part of the gum, in consequence of the increased activity in 
the blood-vessels, be in any way looked upon, as a morbid 
phenomenon, but merely as one, which is physiologically ne- 
cessary, as well as the whole process. The increased sali- 
vation or dribbling of children, so common at this period, 
cannot either be looked upon as a precursor, or consequence 
of a difficult cutting of the teeth, for this is only the effect of 
the progressing development of the glandular system in ge- 
neral, and particularly in the mouth, which takes place 
about the same time, and of the increasing activity in these 
parts, producing a greater secretion until properly equalized. 

Diarrhoea, which used to be looked upon as a necessary 
consequence of dentition, occurs just as much, before, during 
as after it, and still more frequently dentition runs its course 
without its appearance. 

The cause of this diarrhoea, lies, therefore, by no means, 
in dentition ; nor is it correct that teething, when accom- 
panied by diarrhoea, terminates more easily ; no, not more 
easily, but more weakly and slowly, because every diarrhoea 
interrupts the digestion more or less, carries off a certain 
quantity of juices, necessary for the support of the body, in 
consequence of which, the child loses in strength, and there- 
by in capacity, and the gradual progress of dentition, pro- 
portioned by nature to the organic condition, is arrested. 
In the same manner as diarrhoea is injurious during this pe- 
riod, so does also constipation, which arises from dietetic 
errors, and which interrupts the natural process of nutrition, 



DIFFICULT TEETHING. 247 

interfere with dentition. Both the cause of diarrhoea and 
of constipation, is undoubtedly to be found in the instinct for 
food, which arises about this time, and in the weakness of 
the parents and others, who allow the child every thing at 
an improper time. 

Fever, cough, cold in the head, vomiting, sudden starting, 
when awake or asleep, convulsions, spasms, &c, continued 
to be ascribed to the teeth, without considering that there is 
no analogy or connection between them ; that they appear 
suddenly, before, during, and after the period of dentition, 
under the same type and form, and disappear just as sud- 
denly, and that dentition also is accomplished, without them. 

On the one side, physicians have tried to prove by a series 
of errors, that the enumerated forms of diseases, and many 
deaths, were the consequence of dentition ; and on the other, 
they have exerted themselves to the utmost, to sustain a 
preconceived notion, and to prove by gratuitous supposi- 
tions, which always rested upon a false foundation, and 
which physiologically, anatomically, and pathalogically, 
contradict each other, that not only difficult dentition exists 
as a disease, the cause of which is to be found in some 
disproportion or other of the jaw, the gums, or the tooth ; 
but that this disease is called forth, by the wedging in of 
the tooth in the socket of the jaw, from which it has to 
work its way up, and by the irritation, &c, which in its 
progress of cutting, it exercises upon the gums, stretched 
over the socket, also by the dragging of the nerve. This 
belief has gained ground with the mass of the people, who 
are but too ready to form an attachment for old customs and 
prejudices, notwithstanding so many contradictions and op- 
posite assertions, and thus this idea, which existed at the 
time of Galenus, more than a thousand years ago, has 
maintained itself, not only, among the people, but even 



248 DIFFICULT TEETHING. 

among the greater number of physicians, to the present hour, 
in spite of all experience and refutation. 

Although we cannot deny the omnipotence and wisdom, 
with which the human body is formed, nor the permanent 
order and succession in which the phenomena of the devel- 
opment of this body, from the first germ to the perfect for- 
mation of man, occur, if not violently interfered with, by 
the external world, yet we must admit that during the 
tender age of infancy, some developments progress more ra- 
pidly in certain individuals than in others. But for all this 
the beauty and harmony of the organization of the child is 
such, that dentition can proceed without any sickness or 
without any external influences, though the feelings may 
differ according to the temperament, the sensitiveness, the 
strength or weakness of the body. 

In spite of all prejudices, every observer must admit, that 
the majority of children, particularly those of healthy pa- 
rents, with pure air, bodily cleanliness, proper diet, and a 
hardy manner of living, pass the period of dentition without 
any phenomena of sickness, and also, that those, who during 
the period are attacked by other diseases, or carried off by 
death, were seldom without some defect or morbid disposi- 
tion to sickness. Dentition, therefore, cannot be looked upon 
as a disease, but as a process intended by the laws of nature. 
This natural process, namely, dentition, is divided into 
two periods. The first occurs, when the tooth commences 
to swell in the sac, drives the upper part of the gum up, and 
thus forms an elevatiou upon its surface. The second oc- 
curs, when the covering part of the gum bursts, and the 
crown of the tooth grows more into sight. 

Cleanliness of the body, healthy milk, or other proper 
diet, the enjoyment of pure, fresh air, early hardening of 
the body, by washing and bathing of the child, first with 



FINAL REMARKS. 249 

tepid, and later, with quite cold water, make teething so 
easy, that we can scarcely ever perceive an interruption in 
the health of the child. 

If, in consequence of its irritability, the development pro- 
ceeds too fast, and the child becomes uneasy, or on account 
of increased sensitiveness, it cannot sleep, or the skin becomes 
hot, &c, it should be well washed several times, over the 
whole body, with cold water, be wrapped up wet, in a dry 
linen sheet, and then put into bed. 

If, within a few hours, after this, the phenomena that is 
the too great reaction, caused by the cutting of the tooth, 
and by the excitability of the child, does not diminish, it 
should be enveloped in wet rags, which must be changed 
every hour or every two hours until the violent phenomena 
cease, which always takes place within a short period. 

If other accidents, such as fever, diarrhoea, vomiting, con- 
vulsions, spasms, &c, concur, they should be treated accor- 
ding to the rules laid down under these different heads, not 
neglecting, when there is determination of much heat to the 
head, to apply cold fomentations. 



FINAL REMARKS. 

I shall now take the liberty to observe, that this work 
has not been written from any interested motive, that I do 
not rely entirely upon hydropathic treatment, or that I want 
to maintain, that we can altogether dispense with medicines ; 
exactly the contrary is the case, and the work, which I shall 
shortly publish, will give a convincing proof of my assertion. 

The principal reason which induced me to publish this 
w T ork, is the necessity, which is felt for it by many physicians, 
but particularly by families in self-treatment, as both the fair- 



250 FINAL REMARKS. 

sex and the delicate child suffer but too much from the 
taking of medicines. The United States are full of Quacks, 
who assume the name of doctor, who laud their own nos- 
trums to the skies, and sell an incredible quantity of them 
to the masses, who do not know who manufactures them, 
and what injury they may do to the delicate constitution of 
a child. These quack medicines are pretended to cure all 
the diseases under heaven, and yet there are physicians who 
recommend them, a thing most incomprehensible. Better 
for a medical man, when he finds his knowledge insufficient 
to prescribe further for a patient, to admit the fact candidly, 
than to prescribe these nostrums, the ingredients of which 
he does not know, relying solely upon the fabulous descrip- 
tions of the venders. 

I hope that physicians, who make use of them, will begin 
to think for themselves, and see that their conduct must in- 
juriously affect themselves, and their reputation. 

Altogether I should think that every reflecting human 
being, who has daily an opportunity of witnessing the 
baneful consequences of such medicines, would rather take 
no medicine at all, than that, of which he knows neither the 
maker, nor the component parts, and which, principally with 
delicate children, are not only useless, but invariably pro- 
duce injurious consequences.* 

* The author is ready to prove authentically, the valdity and truth 
of the histories of disease, which have been related in this work, and 
in all anal gous cases to give a test of the practicability of his treat- 
ment at his own dwelling, or at any other convenient place. 



THE END. 



3477 



